Did you know the Academy helped put an extra $200 in your pocket for every eye surgery you did in 2014? What’s more, that’s just one of several ways the Academy put cash in your pocket or defended your practice and your patients.
- Medicare payments: By helping to overturn a 24 percent Medicare cut last year, the Academy protected about $200 for every eye surgery you performed last year. Multiply that $200 by the number of cataract surgeries or other procedures you performed last year and it adds up to thousands of dollars in your pocket!
- Billing codes: The Centers for Medicare and Medicaid Services questioned the value of 16 ophthalmology billing codes in 2014: six for retina, four for glaucoma and six for eyelid surgeries. The Academy’s health policy committee defended each code. As a result, CMS accepted the Academy-recommended values for all ophthalmology codes in the 2015 fee schedule. This is very significant, especially considering that all medical specialties (as well as primary care physicians) are having their billing codes constantly reviewed — and reduced — by CMS.
- Research funding: The Academy won extra funding for the National Eye Institute. Because of those efforts, physicians in research and academics have access to an extra $2.1 million, pushing the NEI’s annual budget to more than $684 million.
- Avastin access: Academy leadership does much more than just helping out our bottom lines. They’re also fighting to maintain patient choice for treatments such as Avastin by standing up to those pharmaceutical companies that want to do away with cheaper compounded and generic drugs.
- Patient safety: The Academy successfully limited the use of lasers to ophthalmologists in the Veterans Affairs system. They’re also monitoring the Optometric Equity in Medicaid Act and another bill that would grant loan-repayment benefits for optometrists under the heading of primary care.
- Physician leaders: Last but not least, the Academy worked with other groups in organized medicine to help keep 17 physicians in Congress during the 2014 elections, including one ophthalmologist who is a U.S. senator.
The Academy has its work cut out for 2015, especially with the fight to maintain the value of current eye codes and to introduce new ones, like an eye code for intrastromal rings. Especially troublesome though, is the 21 percent Medicare cut that is scheduled to take effect April 1 and the CMS plan to do away with the global payment package for surgeries.
Currently, CMS pays a bundled payment for surgery. For example, cataract surgery includes payment for up to four postop visits. If CMS eliminates the global reimbursement, patients will need to be billed separately for preop and postop visits, putting the surgeon at risk for nonpayment or patient noncompliance with visits.
This is a huge issue affecting all surgeons. The Academy, the American Medical Association and the American College of Surgeons are all making this a top priority.
What you can do to help
I’m continually in awe of everything the Academy has done for us and the plans they have for our future. What’s even more impressive, though, is that the physicians who fight for us do so on a purely volunteer basis. They fly to Washington, D.C., and meet with officials, committees and other bureaucrats all year round, while simultaneously balancing their own office duties and family lives.
They do all this because they believe it’s their responsibility and a duty to our profession. That’s why it is so important for us to start giving now. Even if it’s just $10 or $20, it all helps. Every dollar given to the OPHTHPAC® or Surgical Scope funds is used to promote and protect the well being of our profession, our practices and our patients.
It’s a “Help Us Help You” campaign, and we are truly getting a significant bang for our buck.