Medical Community Advocacy Prompts Anthem to Fully Rescind Payment Cuts for E&M Codes Billed with Modifier 25

Following reports that Anthem notified physicians in many states that it will begin reducing payments by 50% for evaluation and management (E&M) codes reported with a Current Procedural Terminology (CPT) modifier 25, the medical community intervened to prevent the cuts. In response, Anthem has announced that it will not move forward with its planned payment cuts. Last month, Anthem had originally responded to the medical community’s advocacy by lowering the proposed reduction to 25%.

In Major Legislative Win, Congress Passes Legislation that Includes a CR, Two-Year Budget Deal, IPAB Repeal, and ASCRS-Requested Technical Changes to MACRA Law

Early this morning, years of advocacy by ASCRS, the Alliance of Specialty Medicine, and the medical community have paid off in the form of IPAB repeal and much-needed technical changes to MACRA.

Clinical Alert: Intraocular Use of Epinephrine to Maintain Mydriasis during Cataract Surgery

Issued on December 13, 2017, by the American Society of Cataract and Refractive Surgery

A recent alteration in the formulation of epinephrine from one of the more common sources of preservative-free epinephrine has contributed to a shortage or impending shortage of this product for ophthalmologists. In January 2017, PAR Pharmaceutical updated and began shipping the new formulation of epinephrine which in addition to containing 0.457 mg of sodium metabisulfite, will also contain 2.25 mg of tartaric acid per ml.

Kerry D. Solomon, MD, Named 2016 ASCRS President

FAIRFAX, Va. – Jan. 5, 2016 – Kerry D. Solomon, MD, an internationally recognized leader in cataract surgery, LASIK vision correction and dry eye therapy, will assume his role as the 31st president of the American Society of Cataract and Refractive Surgery (ASCRS) in May 2016. He currently serves as ASCRS vice president and will replace the outgoing president, Robert J. Cionni, MD. Dr. Solomon will deliver the president’s address Saturday, May 7, 2016, during the Opening General Session of the 42nd annual ASCRS•ASOA Symposium & Congress in New Orleans.

New Version of 2014 ASC Specifications Manual Released

CMS released a new version of the 2014 Ambulatory Surgical Centers (ASC) Quality Reporting Program Specifications Manual.  

The new manual reflects the January 1, 2015 delay of Measure ASC-11: Cataracts- Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery (NQF #1536).  This measure was delayed as a result of efforts by ASCRS, the American Academy of Ophthalmology (AAO), the Outpatient Ophthalmic Surgery Society (OOSS) and the Ambulatory Surgery Center Association (ASCA).  

CMS Releases Individual Medicare Provider Data; ASCRS Will Respond

As we indicated last week, CMS announced they would be releasing individual Medicare provider data this week despite the opposition of ASCRS and the entire medical community. This morning, CMS released the information to the public, including the number and type of Medicare healthcare services that individual physicians and certain other healthcare providers delivered in 2012 and the amount that Medicare paid them for those services. The data release has been covered in all the major newspapers across the country and ophthalmology is prominently featured.