• Regulatory Relief for Physicians

    Issue 

    Federal regulations burden physicians with complex and meaningless administrative requirements. These regulations don’t help our patients. They draw our focus away from the care of those who rely on us. The Academy wants changes to existing policies to drive meaningful physician-quality evaluations. We advocate for changes that can create better outcomes, processes and physician-patient interactions. We also want to halt the current use of flawed cost-measurement policies that Medicare phasing out in its new programs. For instance, cost is zeroed out as a measure in the Merit-Based Incentive Payment System’s first year, in response to the Academy’s objections. However, it is still used to evaluate physicians in their 2016 value-based modifier performance. The Academy believes that if a measure isn’t appropriate for a physician in the future, it’s also not appropriate for today.  

    What the Academy is doing 

    We’re capitalizing on a renewed interest in reducing federal regulations in Washington, D.C. One of President Trump’s first acts in office was to issue an executive order requesting the repeal of two regulations for each new one. This signals a shift in the federal landscape unlike any we’ve seen over the past decade.  

    This allows ample opportunity to pursue changes that benefit physicians and our patients. Our regulatory-relief initiative can be viewed in two phases:  

    1. Immediate penalty relief for 2018 and
    2. Changes to simplify Medicare’s new physician payment system.

    Continuing, harsh penalties could compel ophthalmologists to forgo seeing new Medicare patients. We cannot let this happen, especially as our pool of seniors in need of eye care grows. The forthcoming Quality Payment Program provides some relief, but not until 2019. For example, ophthalmologists immediately face significant penalties from current quality programs. CMS will use their 2016 performance to enact penalties in 2018. These penalties could total as much as 10 percent of physicians’ Medicare revenue.  

    We want Congress to halt these penalties, which are tied to the Physician Quality Reporting System, the value-based modifier and meaningful use. Meanwhile, we’re pursuing regulatory and legislative changes that can help ensure that the Quality Payment Program is easy to participate in and does not put ophthalmologist at a disadvantage.  

    Leaning on the experiences of ophthalmologists Hundreds within the Academy’s community of U.S. ophthalmologists helped shape our regulatory-relief campaign. Your stories of how existing regulations have interfered with physician-patient relationships help us show the real consequences to care that federal regulators could never have anticipated. We have already shared specific examples provided by Academy members with leaders in Congress and the U.S. Department of Health and Human Services. Leading a coalition that spans specialty medicine We get by with a little help from our friends. That’s why we secured the support of oncology, otolaryngology, dermatology, rheumatology, urology and others in this initiative.  

    Our coalition is united in the belief that the current programs don’t treat specialists fairly. Directly engaging with U.S. Health and Human Services Secretary Tom Price, MD We have the ear of one of the nation’s most powerful physicians. In March, we met directly with HHS Secretary Tom Price, MD, and his senior staff, giving us rare facetime with the people making this country’s major health care decisions. Secretary Price has vast regulatory powers to limit penalties associated with quality programs; we want him to use them.  

    Enlisting congressional champions to quality patient care Congress is working for ophthalmology and other physicians by urging immediate action by Secretary Price. Led by Rep. Phil Roe, MD, R-Tenn., members of Congress sent a letter requesting that he direct the Centers for Medicare & Medicaid Services to limit penalties associated with the value-based modifier, meaningful use program and PQRS. Hundreds of Academy members reached out to their lawmakers to help secure the support of their member of the U.S. House of Representatives.  

    Next steps 

    We continue the conversation with federal leaders. We press forward showing the true ramifications of regulations on our patients. There is no more valuable a resource than real stories of patient care.