Advocacy News

Academy Secretary for Federal Affairs George Williams, MD, discusses what the Academy is doing to support retina physicians, particularly related to use of modifier -25. He also offered some perspective in the context of the recent Office of the Inspector General report.

The Centers for Medicare and Medicaid Services should soon release its proposed 2016 Medicare Physician Fee Schedule. The massive fee-schedule rule will include the estimated conversion factor CMS will use to calculate 2016 physician payments, details of the 2016 Physician Quality Reporting System and a list of the “potentially misvalued codes” CMS wants reviewed.

A new law signed by President Obama last week extends cuts to Medicare physician pay through 2024. The law extends the 2 percent cut on physician pay caused by sequestration, across-the-board cuts in federal spending, through 2024. This is the second time in two months that lawmakers have enacted legislation that is funded by extending the cut to physician pay.

As of April 1, Medicare physician claims submitted for reimbursement are being reduced by 2 percent as part of across-the-board cuts in federal agency spending caused by the sequestration process. Costs for drugs administered by the physician that are included in those claims are also subject to the 2 percent cut.