This Year’s Laureate: Marilyn T. Miller, MD, MS
The Board of Trustees of the Academy is proud to announce Marilyn T. Miller, MD, MS, as the recipient of the 2019 Laureate Recognition Award. She is currently professor of ophthalmology at the University of Illinois at Chicago, Illinois Eye and Ear Infirmary.
Early roots. Dr. Miller obtained her medical degree and clinical training in ophthalmology at the University of Illinois School of Medicine in 1959. Following her residency and fellowship at the Illinois Eye and Ear Infirmary, she stayed on to become director of pediatric ophthalmology and strabismus. It was during this time that she developed her main area of interest—craniofacial syndromes and malformations.
Service abroad. Dr. Miller’s subsequent work resulted in journeys around the world. Her research in congenital anomalies and teratogens first led her to Sweden, where she was subsequently awarded an honorary degree from the University of Gothenburg. Dr. Miller’s adventurous spirit and compassion for those in need also inspired her to look toward underserved regions across multiple continents to help in the fight against blindness. Of particular note, she visited a clinic in rural Nigeria for more than 35 years with a small nongovernmental organization, FOCUS, of which she is now president.
Career honors. Dr. Miller’s work has not gone unrecognized. In past years, the Academy has awarded her with both the Humanitarian Award and the International Blindness Prevention Award as well as a Lifetime Achievement Award. She is especially proud of her recent Howe Medal from the American Ophthalmological Society (AOS) for distinguished service to ophthalmology.
She also holds the honor of being the first female president of both the AOS and American Association for Pediatric Ophthalmology and Strabismus and has served on many ophthalmic boards and advisory committees, including those of the Academy and the Academy Foundation. In addition, Dr. Miller established and chaired the Academy’s Committee on International Ophthalmology and served for many years as one of the Academy’s representatives to the International Agency for the Prevention of Blindness.
Celebrated in San Francisco. In recognition of Dr. Miller, the Academy will honor her as the 2019 Laureate during the Opening Session of AAO 2019 in San Francisco. At AAO 2019, read about Dr. Miller’s life and accomplishments in AAO 2019 News, a convention tabloid distributed onsite.
Maryland Puts Spotlight on ECA’s Anniversary
In 2020, EyeCare America (ECA) will celebrate its 35th year of volunteer ophthalmologists providing free eye care. In celebration of ECA—and all Maryland ophthalmologists—Governor Larry Hogan is expected to sign a special proclamation that “honors EyeCare America and its dedicated volunteers for thirty-five years of public service to people in need in the state of Maryland and throughout the U.S.”
The Maryland Society of Eye Physicians and Surgeons (MSEPS) drafted the proclamation, and, currently, the society’s leaders are planning to host a signing ceremony with Governor Hogan in January.
MSEPS Past President Lee A. Snyder, MD, noted, “This was a no-brainer—ECA has been an amazing public service program, and MSEPS is proud to partner on this program, which makes a difference in the lives of underserved patients, not only in Maryland, but nationwide.”
Other state ophthalmology societies are encouraged to follow Maryland’s lead in obtaining a proclamation from their respective governors. For questions on how to take action and to receive a draft proclamation, contact Betty Lucas (email@example.com), director of ECA.
MIPS Alert! Don’t Miss These October Deadlines
If you are participating in the Merit-Based Incentive Payment System (MIPS), note two upcoming deadlines.
By Oct. 3, start your 90-day performance period. You must perform improvement activities and promoting interoperability measures for at least 90 consecutive days. (The performance period for quality measures and cost measures is the full calendar year.)
Reading this after Oct. 3? There are some improvement activities that your practice may have been performing and documenting as a matter of course. For example, IA_EPA_1: Provide 24/7 access to eligible clinicians or groups who have real-time access to patient’s medical record.
By Oct. 31, sign up to use the IRIS Registry for MIPS reporting via manual data entry. If you were signed up for IRIS Registry manual reporting in 2018 and are still in the same practice, there is no need to register again for 2019. Similarly, if you signed up to integrate your electronic health record (EHR) with the IRIS Registry, you don’t have to sign up separately for manual reporting. (Note: Although quality measures can be reported via IRIS Registry–EHR integration, you must report improvement activities and promoting interoperability measures manually.)
Not sure how to access the IRIS Registry? To learn about the application process, visit aao.org/iris-registry and click Sign Up at the top of the screen. If you are already registered, email firstname.lastname@example.org for assistance with your login credentials.
Getting Started With MIPS
Haven’t started on MIPS? Don’t delay any longer. Your MIPS performance in 2019 impacts your payments in 2021. If your MIPS final score is less than 30 points, your payments for Medicare Part B services will be reduced by up to 7% in 2021.
How to get started. Make sure you are signed up to use the IRIS Registry (see above), and also visit aao.org/medicare, where you’ll find the Small Practice Roadmap and the Large Practice Roadmap, as well as detailed descriptions of quality measures, promoting interoperability measures, and improvement activities. And you also can visit aao.org/eyenet/mips-manual-2019 for at-a-glance lists that link to those detailed measure and activity descriptions.
Coming to AAO 2019? If you bring your IRIS Registry login credentials, staff at the Academy Resource Center (West, Booth 7337) can help you report your improvement activities, help you sign your Data Release Consent Form, and show you how to report quality measures via manual data entry.
FOR THE RECORD
Vote in Academy Elections
The election for open positions on the Board of Trustees and voting on the proposed amendments to the Code of Ethics begins on Oct. 14 and closes on Nov. 12 at noon EST. Election materials will be sent to all voting Academy fellows and members. Results will be posted at aao.org/about/governance/elections by Nov. 15, 2019.
Understanding Medicare’s Significant Cataract Cuts
In August, the Centers for Medicare & Medicaid Services (CMS) released its proposed 2020 physician fee schedule, which includes a significant decrease in cataract reimbursements.
For context, it is helpful to know some important background details.
CMS’ misvalued codes initiative puts cataract reimbursement under pressure. In 2018, the American Medical Association–convened Relative Value System Update Committee (RUC)—acting on behalf of CMS—was charged with determining whether cataract fees needed to be adjusted, taking into account the procedure’s time and intensity, as well as postoperative care.
Academy and ASCRS teamed up to protect values. In a move to support a favorable decision, the Academy and the American Society of Cataract and Refractive Surgery combined efforts to defend values for cataract fees, including jointly surveying ophthalmologists to obtain RUC-required data. The member survey showed a median skin-to-skin time of 20 minutes for “typical” cataract surgery. It also revealed that most cataract procedures were followed by three postoperative visits in the first 90 days, a contrast to the four currently bundled into the reimbursements.
Academy fought, mitigating much steeper cuts. When medical specialties debate values before the RUC, this kicks off an intense back-and-forth negotiation on time, intensity, and relativity. In the case of cataract surgery, RUC members considered reductions as high as 40% based on the survey data. Following the Academy’s presentation to the RUC and intense adjudication, the RUC voted to recommend reducing the fee by 15% in 2020. CMS announced that it has accepted that value. A large portion of the cut is due to the loss of payment for a fourth postoperative visit.
Learn more at aao.org/eye-on-advocacy-article/understanding-medicare-s-significant-cataract-cuts.