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    Academy-Led Coalition Briefing Congress and Media on Effect of E/M Changes


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    The Academy and our partners in the Surgical Care Coalition are reaching out to media outlets and members of Congress to inform them about the drastic consequences that planned Medicare evaluation and management (E/M) coding policy changes could have on physician practices and patients’ access to care. The effect will be especially profound for surgical care.

    Because of the policy changes that the Centers of Medicare & Medicaid Services intends to implement in less than five months, ophthalmology and other surgical specialties are facing significant Medicare payment cuts.

    Starting Jan. 1, the overall cut for ophthalmologists will be 6% and up to 9% and 10% for some of our subspecialties—such as glaucoma, cataract and retina.

    Surgical specialties would be hit twice because CMS decided not to apply the E/M updates to post-operative visits that are bundled into global surgical payments. These cuts will have devastating consequences for ophthalmology and other physician practices already struggling from the negative effects of the COVID-19 pandemic.

    Members of the Surgical Care Coalition have had articles published in major media outlets across the country, including an op-ed on CNN.com, in August. More examples of the coalition’s publications can be found here. This media attention and other advocacy efforts are putting pressure on congressional leaders to act. If you would like to submit an op-ed or otherwise participate in the social media campaign, contact the coalition at media@surgicalcare.org.

    The Academy is extremely disappointed that CMS did not heed the surgical community’s warning about the devasting effect its E/M policy changes could have on access to patient surgical care. The Surgical Care Coalition, which the Academy co-founded with the American College of Surgeons, is ramping up efforts to pressure Congress to:

    • Waive Medicare’s budget neutrality requirements, which would allow CMS to implement payment increases for E/M visits but avoid drastic payment cuts to other physician services. Under budget neutrality, those cuts are required to offset the costs associated with the way CMS wants to do it—through an add-on code.
    • Require CMS to apply the increased E/M payment to 10- and 90-day global surgical post-operative visits as it has always done in the past.

    Outreach to Congress

    The Academy is also working with other ophthalmic organizations to contact members of Congress and their staffs about the devastating consequences from the E/M policy changes. The American Glaucoma Society, ASCRS, the Eye Bank Association of America, administrators with the American Academy of Ophthalmic Executives® (AAOE®) have committed to generate messages from ophthalmologists and ophthalmic staff to congressional offices to prompt action to avert the negative effect the E/M changes will have on physicians and patients in their communities next year.

    Academy members from nearly 50 congressional districts in over a dozen states have signed up to meet with their congressional offices to discuss the negative effect of these E/M changes during Congress’ August recess period. The Academy will continue to connect our members directly with their elected officials through the end of the 116th Congress and into next year.

    Get Involved

    Here’s what you can do to partner with thousands of other physicians and make an impact for your profession:

    • Call your members of Congress today.
      • Urge your legislators to preserve patient access to surgical care and stop drastic payment cuts for surgical services.
      • Call 202.224.3121 and ask to be connected to your elected officials’ offices.
      • Use our Academy talking points (PDF) to guide your discussion.
    • Make your voice heard.
      • Use the Academy’s advocacy tool to send a letter to your elected officials to act to prevent Medicare fee cuts for surgical and other physician services
      • Learn more about joining our Congressional Advocate program.
    • Join OPHTHPAC®.
      • The Academy is leveraging OPHTHPAC’s relationships with congressional champions to get Congress to stop these payment cuts and apply the increased E/M adjustment to the 10- and 90-day global code values.
      • Academy member support of OPHTHPAC is critical to our success.
      • Join our efforts!

    We will continue to keep you updated on this issue and our efforts to protect your ability to serve patients during the ongoing pandemic.