Advocacy News

The Centers for Medicare & Medicaid Services has acceded to Academy-led efforts to eliminate or at least reduce the unnecessary burden imposed by CMS’ prior authorization program for hospital outpatient department services, including removing CPT code 67911, a type of corrective lid surgery, from the list.

The Centers for Medicare & Medicaid Services has finalized a payment increase for hospital outpatient departments and ambulatory surgery centers in its 2022 Medicare Hospital Outpatient Prospective Payment System and the Ambulatory Surgical Center (ASC) Payment System rule. This rule affects hospital outpatient departments and ambulatory surgery centers only.

Overall rate increases of 2.3%, yes. Extended pass-through status for some drugs and biologics, yes. Inadequate payment for newly combined MIGS and cataract codes, no.

Global surgical payments and values for MIGS, cataract surgery and strabismus codes are among the key targets of our latest effort to show CMS where it needs to adjust its proposed 2022 Medicare physician fee schedule.

What Medicare reimbursement and physician payment reforms are on the horizon and how does Medicine break out and restore equity for physician payment?

Congress’ deal infuses $3 billion into the physician payment system to reduce the negative effect of the policy changes for evaluation and management (E/M) services that the Centers for Medicare & Medicaid Services (CMS) will implement in January.

The year 2020 was a busy one for the Academy's health policy advocates. Here is a rundown of our top issues.

A recent Academy survey indicated that 13% of our members now say they use telehealth services to treat patients.

Services provided outside of the hospital outpatient setting — including ambulatory surgery centers — are not subject to the new prior authorization requirements.  

Medicare’s forthcoming 2021 change to E/M reimbursement, as currently configured, will have a devastating effect on ophthalmology.