In dramatic attempts to control costs, Medicare Advantage plans across the country have been narrowing their networks by terminating their contracts with ophthalmologists and other specialists. The Academy has been working with the American Medical Association, other physician organizations, and lawmakers to address these unfair terminations, but physicians are still being dropped from Medicare Advantage plans daily. The Academy will continue to develop resources to help members deal with Medicare Advantage Plans.
Several ophthalmologists have recently been successful in appealing their removal from Medicare Advantage networks. The Academy has worked with these physicians to create tips for writing a strong appeal letter.
Physicians who wish to proactively reach out to patients when they are dropped from the plans can use the template patient letter about terminations from Medicare Advantage and commercial plans [DOC 26K].
A Frequently Asked Questions document is now available from the recent free webinar sponsored by the Academy and the American Society of Retina Specialists designed to help physicians evaluate and respond to contract policies to maximize reimbursement in the Medicare Advantage program. In addition to this new tool, you can also view a recording of the webinar, “Medicare Advantage Contract Negotiations: What You Need to Know.” It is currently available on demand for members who were not able to participate in the live event. The Medicare Advantage Contracting FAQ, prepared by the presenter Catherine Hanson, JD and the recording are available now. Members must register to view the recording. Previously registered attendees can log in to view the recording using the email address used for registration.
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