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.
Academy Meets With Aetna on Prior Authorization Reforms
Florida and Georgia state societies joined the Academy in driving home the burdens of prior authorization.
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February 15, 2023
New Report Confirms Rising Prior Authorization Denials in Medicare Advantage Plans
The report from the Kaiser Family Foundation documents how Aetna uses prior authorizations to deny or delay medically necessary care.
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December 7, 2022
CMS Released Proposed Rule That Could Ease Passage of Prior Authorization Reform Bill
We pushed CMS to release the rule, which would reduce the cost of this important bill to entice Senate action by the end of the year.
August 31, 2022
Academy Urges CMS to Address Prior Authorization, Other Burdens in Medicare Advantage Plans
We raised concerns about how these delays in treatment exacerbate health care disparities.
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July 6, 2022
The Real Heroes Behind Aetna’s Cataract Reversal: Surgeons Like You
Member stories powered the Academy’s successful advocacy against prior authorization.
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June 29, 2022
Humana to Launch Cataract Prior Authorization in Georgia
The Academy is urgently meeting with Humana regarding the insurer’s newly announced policy to require prior authorization for Medicare Advantage members in Georgia for cataract procedures.
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June 28, 2022
Aetna Drops Prior Authorization for Most Cataract Surgery
Aetna has announced that starting July 1 it will stop requiring prior authorization for most cataract surgeries.
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May 18, 2022
Academy Shares Your Step Therapy Stories With CMS to Urge Policy Reversal
The Academy met with the Center for Medicare & Medicaid Services and other physician and patient groups to ask the agency to reinstate a step therapy prohibition for Medicare Advantage plans for Part B drugs.
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April 27, 2022
Report on Medicare Advantage Abuse Proves Need for Prior Authorization Reform
A new Office of Inspector General report has found that tens of thousands of patients enrolled in Medicare Advantage plans are denied necessary care and misuse of prior authorization.
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April 27, 2022
UnitedHealthcare’s New Medicare Advantage Site-of-Service Prior Authorization Starts May 1
The insurer will require preapproval for 19 ophthalmic procedures in hospital outpatient department covered by its Medicare Advantage plans starting May 1
