News and views on the regulatory, legislative, and political issues impacting ophthalmology in Washington, D.C., and around the United States
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2027 Fee Schedule Proposes Cutting Pay to Physicians by 1.68%
The Centers for Medicare & Medicaid Services (CMS) has released its proposed Medicare Physician Fee Schedule for 2027. Here are the highlights based on the Academy’s analysis. The Academy will work with our advocacy partners to ensure finalized policies support our members and their patients.
House Republican Budget Bill Includes Medicare Physician Payment Reforms
It does not include a fix for 2025 cuts, but the process is far from over. See where things stand after the Energy and Commerce Committee vote.
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May 14, 2025
CMS Suspends 8 MIPS Improvement Activities for 2025
Suspended activities include those related to staff vaccination rates and health equity data analysis. Physicians are advised to report other activities from the updated inventory.
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May 11, 2025
CMS Opens 2025 MIPS Exception Applications
Applications must be submitted on the Centers for Medicare & Medicaid Services Quality Payment Program webpage by 8 p.m. ET on Dec. 31, 2025.
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March 5, 2025
Academy Health Policy Committee Sets Strategy for 2025 Key Advocacy Priorities
The Academy’s Health Policy Committee consulted with Academy staff on many of the top advocacy issues arising from the January 2025 Federal Secretariat meeting.
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February 26, 2025
Academy Pushes Against Humana Downcoding Higher-Level Claims
Responding to members’ request for assistance, the Academy is fighting policies that assign lower reimbursement for certain high-level services.
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February 5, 2025
Automatic MIPS Exceptions for Practices Affected by California Wildfires
The Centers for Medicare & Medicaid Services (CMS) will apply the automatic extreme and uncontrollable circumstances (EUC) policy to eligible physicians in Federal Emergency Management Agency-designated counties in California.
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January 29, 2025
Academy Leadership Sets 2025 Advocacy Priorities
Academy leaders have identified physician payment reform, reducing practice burdens, Medicare Advantage and Quality Performance Program issues, as well as military veterans’ eye care as some of our top federal advocacy priorities for 2025.
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January 22, 2025
First MIPS Value Pathway for Ophthalmology Available for 2025 Performance Year
This new reporting option is available for voluntary reporting for the 2025 MIPS performance year/2027 payment year.
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January 8, 2025
Advocacy Works: WPS Corrects Billing and Coding Article for Cataract Surgery
WPS accepted the Academy’s recommendation to correct its cataract surgery billing and coding article in response to denials of CPT 66982 billed with mature cataracts.
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December 18, 2024
Advocacy Works: Noridian Will Correct Denials for Retina Imaging Test and Injections
Noridian informed the Academy that a claims processing editing error caused denials and is working on a fix.