Advocacy News

The key provision from the Inflation Reduction Act is not expected to affect ophthalmic drugs in the short term.  

We raised concerns about how these delays in treatment exacerbate health care disparities.

Member stories powered the Academy’s successful advocacy against prior authorization.    

Aetna has announced that starting July 1 it will stop requiring prior authorization for most cataract surgeries.  

The Academy has joined 120 state medical and national specialty societies to help develop and endorse the American Medical Association’s Characteristics of a Rational Medicare Physician Payment System.  

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.      

The Academy has joined the AMA and other medical groups in an effort to change the Medicare physician payment system to improve the financial viability of physician practices and ease their administrative burdens.  

The insurer will require preapproval for 19 ophthalmic procedures in hospital outpatient department covered by its Medicare Advantage plans starting May 1

The Academy and partner groups educated the Department of Health and Human Services Office of the Inspector General on modifier -25 in an effort to end unnecessary audits.

Nine out of 10 physicians surveyed by the American Medical Association said for patients whose treatments required prior authorization, the process had a somewhat or significant negative effect on their clinical outcomes. The Academy continues to work with our members and partners to press for reform.