MedPAC Considers Options for Reducing Spending on Separately Payable Drugs Administered During Outpatient Surgery and Discusses Strategies for Increasing Specialist Participation in APMs
Separately Payable Drugs
This week, the Medicare Payment Advisory Commission (MedPAC) met to discuss separately payable drugs in the hospital outpatient prospective system (OPPS), which includes ASCs. According to its analysis, spending on separately payable drugs is rising rapidly. Currently, there are two programs in the OPPS for separately payable drugs: pass-through drugs, that are new to the market and high cost, and separately payable non-pass-through drugs. The commission identified a major area of concern with these programs is that neither require drugs to show clinical improvement. The commission agreed on the goal to bundle as many drugs as possible into the facility payment and that the determination of whether any drug should be separately payable—whether it is a new pass-through drug or not—would be made using clinical criteria. The commission did not define what criteria would be used to determine the status of separately payable drugs. The commission intends to study this topic further.
Specialist Participation in APMs
In addition, the commission discussed strategies for improving specialist participation and engagement in alternative payment models (APMs). The discussion was prompted by comments from specialty societies, including ASCRS and the Alliance of Specialty Medicine, that specialists’ opportunities to participate in APMs are limited since there are very few specialty-focused models, and existing ones, such as accountable care organizations (ACOs) are primary care-focused and often do not invite specialists to participate. Commissioners noted that measuring specialists’ quality on population-based measures that are primary care-based is not appropriate and suggested re-tooling the ACO program to incorporate more episode-based measures that are relevant to specialists. This month’s discussion was the first in a planned series of discussions and further research on engaging specialists in APMs MedPAC is planning.
This week, the Food and Drug Administration (FDA) issued a draft guidance, “Soft (Hydrophilic) Daily Wear Contact Lenses – Performance Criteria for Safety and Performance Based Pathway,” that provides performance criteria for certain soft (hydrophilic) frequent replacement or daily disposable contact lenses. The purpose of this guidance is to support the new Safety and Performance Based Pathway which allows medical device manufacturers the option to use the performance criteria to support substantial equivalence, rather than comparing it to a device already on the market, known as a predicate device. The goal of this pathway is to ensure that new medical devices, such as contact lenses, coming to market under the 510(k) pathway account for advances in technology that can improve the safety or performance of existing products, or demonstrate that they meet more modern safety and performance criteria.
ASCRS Calls on Members to Assist with FTC Request to Provide Examples of Incomprehensible Prescription Verification Messages
We are calling on ASCRS and ASOA to help with a recent request from the Federal Trade Commission (FTC) staff in regard to the Contact Lens Rule. Recently, ASCRS joined with the American Optometric Association (AOA) and the American Academy of Ophthalmology (AAO), in a meeting with FTC staff to discuss the contact lens market. During the meeting, we reiterated our members' complaints of online retailer violations, especially robocalls that leave incomprehensible verification messages. As a result, the FTC has requested audio files of these prescription verification messages.
Please send any audio examples of incomprehensible prescription verification messages to Jillian Winans at email@example.com. We appreciate your assistance.
On Thursday, March 19 from 2:00–3:00 p.m. ET, CMS will host a call on the Open Payments program. CMS will provide an overview of the Open Payments program, registration process, and will review critical deadlines for physicians and teaching hospitals to review and dispute data. A question and answer session will follow the presentation. Register for the call here.
As a reminder, the data on Open Payments is submitted by manufacturers and group purchasing organizations regarding payments made to physicians. Each year, Open Payments data is updated at least once to include information from disputes and other data corrections. The data is published to the Open Payments website for the public.
Now that registration is officially open for next year’s ASCRS Annual Meeting, eyePAC is excited to announce that the 2020 eyePAC Reception will be held at the New England Aquarium. Overlooking Boston Harbor, the Aquarium features more than 20,000 fish and aquatic animals representing 550 species from around the world. It truly is one of Boston’s most unique event venues!
On Friday evening, May 15, from 7-9:00 p.m., eyePAC donors and their guests will enjoy drinks and substantial hors d’oeuvres surrounded by penguins, sharks, sea turtles, moray eels, and thousands of exotic, colorful fish. You’ll have private access to all four levels of the aquarium’s stunning Main Exhibit Gallery. The four-story Giant Ocean Tank creates a fascinating centerpiece that will long be remembered by you and your guests!
To donate and register for the eyePAC Reception, use your member credentials to log onto www.ascrs.org. Then go to the official registration page. If you have any questions, please contact Chris Hughes, manager of PAC & Grassroots at 703-591-2220 or firstname.lastname@example.org. We hope to see you there so we can thank you for your support of eyePAC—the PAC for anterior segment specialists!
Register Now: ASCRS/ASOA U.S. Domestic Members and ASCRS YES Program Members are Invited to Attend the Annual Alliance of Specialty Medicine Legislative Fly-In in Washington, D.C., June 15-17
Event Info: June 15-17, 2020; Liaison Hotel Capitol Hill; Washington, D.C.
We welcome all U.S. domestic ASCRS and ASOA members to join their colleagues from other specialties in Washington, D.C. this summer for another great Legislative Fly-In event! During this event, you will experience first-hand the importance of meeting with your members of Congress and staff. You will learn how to become an effective advocate and then turn that knowledge into action in-person on Capitol Hill. Please plan to join us for this year’s Fly-In, June 15-17 in Washington, D.C. Up to $1,000 in travel expenses will be reimbursed to each member who attends the Fly-In.
Scholarship Alert: ASCRS/YES Alliance of Specialty Medicine Legislative Fly-In Scholarship
Are you currently an ASCRS Young Eye Surgeons (YES) member or do you know any members who might be interested in attending the annual fly-in event? ASCRS and the Young Eye Surgeons (YES) program are excited to announce a full-scholarship opportunity for U.S. resident and fellow members of ASCRS who want to effect positive change for their profession and patients. Please feel free to forward this announcement! For more information, or to apply for this opportunity, please use the links below:
Legislative Fly-In Background Information:
Each year, members from ASCRS and ASOA make their way to Washington, DC to join the Alliance of Specialty Medicine, a coalition of 14 “like-minded” specialty medical groups that focus on preserving access to specialty care, for legislative “Fly-In” days. All participants will participate in an advocacy briefing session, where you will learn the proper techniques to become effective advocates with your members of congress and their staff. You will then travel to Capitol Hill to meet with your legislators and lobby for shared priority issues. During these meetings, ASCRS and ASOA members will have the opportunities to share personal stories that help illustrate the effect of policies in Washington, and to thank your elected officials for their support on key legislative issues and to encourage their continued support. Traveling to Washington to meet with your members of congress is also a great way to offer yourself as a resource to make sure that accurate information is used in making public policy decisions. We hope that you will consider this opportunity!
MIPS Eligible Clinicians Have Until March 31 to Submit Data for 2019
The data submission deadline for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2019 performance period of the Quality Payment Program (QPP) is next month. Data may be submitted and updated any time until 8:00 p.m. ET on March 31, 2020.
Please note, if you use the IRIS registry, you do not need to submit your data directly to CMS. However, IRIS and other third-party vendors may have earlier submission deadlines than CMS does.
Quality measures reported via Medicare Part B claims have been submitted throughout the 2019 performance period. You may review your preliminary feedback on Part B claims measure data by signing in to qpp.cms.gov. CMS will update this feedback at the end of the submission period with claims processed by your Medicare Administrative Contractor. Additionally, the data submission period through the CMS Web Interface for ACOs and pre-registered groups and virtual groups also closes on March 31, 2020 at 8:00 p.m. ET.
How to Submit Your 2019 MIPS Data and For Additional Resources
To learn how to submit data, please review the 2019 Data Submission FAQs. Additional resources are available in the QPP Resource Library.
For questions or comments on data submission, please contact CMS QPP staff at 866-288-8292, Monday through Friday, 8:00 AM-8:00 PM ET or by e-mail at: QPP@cms.hhs.gov.