AOA Advocacy Leads to Favorable Physician Fee Schedule Rules for ODs

When the Centers for Medicare & Medicaid Services (CMS) issues a proposed rule for the new year, AOA responds strongly to these proposals to ensure that CMS policies are favorable for doctors of optometry. On October 30, CMS released the final Medicare fee schedule policies for 2016 and it is clear that CMS heard doctors of optometry.

AOA wins in the rule for the optometric profession include:

• CMS estimates that Medicare-allowed charges for optometrists will rise to a record $1.178 billion next year.
• At AOA’s urging, CMS chose not to move forward with its proposal to include a checkmark on the Physician Compare website for those physicians who received an upward adjustment under the value-based payment modifier program. AOA argued this information was of questionable value to patients and that the value-based payment modifier program, itself, was not an equitable measure of quality for all physician types.
• In response to AOA concerns, CMS rescinded its classification of CPT 92002 as potentially mis-valued due to high expenditures.
• CMS agreed with AOA that individuals who have been excluded from federally funded programs should be allowed to provide “incident to” services.
• In response to AOA concerns, CMS decided not to move forward with use of a quality measure related to amblyopia screening in children in 2016.  AOA argued that the quality measure was flawed and was not in the best interest of children.
• CMS concurred with AOA that the agency should do away with the one-year waiting period for qualified clinical data registries, which opens up possibilities for AOA MORE (Measures and Outcomes Registry for Eyecare).
• CMS agreed with AOA that there is a need for stability within the Physician Quality Reporting System (PQRS) program and CMS did not increase the number of quality measures required to be reported under PQRS.