ASCRS, Alliance of Specialty Medicine Oppose Misvalued Code Offset Provision in Medicare Extenders Package

This week, ASCRS, in conjunction with the Alliance of Specialty Medicine, sent a letter to House Ways and Means (W&M) Committee Chairman Kevin Brady (R-TX) and Ranking Member Richard Neal (D-MA) in opposition of an offset provision in the committee’s proposed bipartisan Medicare extenders package. As we have reported, the provision would extend the current law policy related to misvalued codes for physician services.

On November 15, W&M reached a bipartisan agreement on the annual package of Medicare payment extensions, known as extenders, and policy fixes to “improve efficiencies” in the Medicare program. The W&M outline included offsets to cover the cost of the extenders, but wasn’t clear on either the cost of the extenders or the amount of the offsets.

The misvalued code provision has been used as a pay-for in the past and can lead to arbitrary across-the-board cuts to Medicare physician reimbursements if annual targets are not met through the revaluation process. ASCRS continues to support revaluation of physician services through the RUC process, and therefore, felt compelled to express our opposition to this provision of the Medicare extenders package, as specialty physicians, including ophthalmologists, will be targeted for the offset.

The Medicare extenders package is expected to be attached to Children's Health Insurance Program (CHIP) reauthorization legislation, which will likely be part of a year-end omnibus spending bill.

A summary of the Medicare-extender package may be found here and includes information about the extenders and the offsets.

We will keep you updated.