House Ways and Means Committee Plans to Release Proposed Bill on Surprise Billing Next Week
House Ways and Means Committee Chair Richard Neal (D-MA) announced Monday that he is aiming to finalize a bill on Surprise Medical Billing and schedule a committee markup for February 12. To date, committee leaders have yet to share any additional details to their proposal beyond the one-page outline released back in December; however, legislation that would rely on outside mediators to settle impasses between insurers and providers is highly anticipated. Such legislation would challenge the existing bipartisan deal between the Energy and Commerce (E&C) Committee and Senate HELP Chairs, a deal that relies on setting a federal benchmark payment with an option of arbitration for some medical bills. Lawmakers are pushing to include legislation in the May spending package, which could also set the stage for a new round of debate. Democratic leadership has already stated that they wish to avoid any fights. On Wednesday, Speaker Nancy Pelosi urged Chairman Neal, E&C Chair Frank Pallone and Education and Labor Chair Bobby Scott to quickly work out any differences.
Other potential complications are also looming, as the House Ways and Means Education and Labor Subcommittee also shares jurisdiction, and subcommittee Chair Lloyd Doggett (D-TX) said on Tuesday he has not seen any policy details beyond the one-pager. Also, expensive lobbying efforts from stakeholder groups that oppose the E&C proposal because of its inclusion of benchmark payment rates, whom are also withholding support for the Ways & Means plan until more information has been released, are slowing negotiations and convincing lawmakers to reconsider what course they will take.
ASCRS and the Medical Community Call on CMS to Reinstate Measures Removed from the 2020 MIPS Program, Cataract Surgery Measures Cited as Example
This week, ASCRS joined with the medical community in a letter to CMS advocating that the agency rethink its “Meaningful Measures” initiative and refrain from removing outcome and other high value measures from the MIPS program. The letter recognizes that CMS is seeking to streamline and simplify the MIPS program by paring down the number of measures available to report, however, the unintended consequence is that it is removing measures many specialists use. The two cataract surgery measures removed for the 2020 year (192, Complications within 30 Days of Cataract Surgery Requiring Additional Surgical Procedures and 388, Cataract Surgery with Intra-Operative Complications, Unplanned Vitrectomy) are cited specifically in the letter as examples of clinically relevant outcome measures that track surgical complications and patient safety. The letter asks that these and other measures removed for 2020 be reinstated so that specialists, such as ophthalmologists, will continue to have relevant measures available.
In addition, the letter asks for additional flexibility in the qualified clinical data registry (QCDR) program. The letter notes that CMS’ increased testing requirements for new QCDR measures are onerous and many QCDRs lack financial and other resources to comply with them. Similar to the Meaningful Measures initiative, the letter notes that CMS’ policy is having the unintended consequence of forcing some QCDRs to leave the program.
Get the Inside Scoop on the 2020 Electoral Outlook: Don’t Miss ASCRS’ Government Relations Symposium, “Inside the Circus” featuring Mark McKinnon at the ASCRS Annual Meeting in Boston, MA
On Sunday May 17, from 1–2:30 p.m. join Mark McKinnon, co-creator, co-executive producer, and co-host of Showtime’s “The Circus: Inside the Greatest Political Show on Earth” at the ASCRS government relations symposium, “Inside the Circus.” McKinnon, a political advisor, reform advocate, and media columnist, will provide a non-partisan take on the electoral landscape and its impact on ophthalmology.
McKinnon has helped engineer five winning presidential primary and general elections including former President George W. Bush, Senator John McCain, and former Governor Ann Richards. He is co-founder of No Labels, a nonprofit organization dedicated to bipartisanship.
Don’t miss this exciting session to hear how the current political climate may impact you!
CMS Updates Open Payments Data
This week, CMS announced it has updated its Open Payments database with changes to its dataset that have occurred since its last update in June of 2019. The refreshed Open Payments data includes:
- Record Updates: Changes to non-disputed records that were made on or before November 15, 2019, are published.
- Disputed Records: Dispute resolutions completed on or before December 31, 2019 are displayed with the updated information. Records with active disputes that remained unresolved as of December 31, 2019 are displayed as disputed.
- Record Deletions: Records deleted before December 31, 2019 were removed from the Open Payments database. Records deleted after December 31, 2019, remained in the database, but will be removed during the next data publication in June 2020.
As a reminder, the Open Payments database tracks payments and transfers of value of more than $10 between manufacturers and physicians or academic institutions. If you need additional information, please contact Jillian Winans, regulatory affairs specialist, at email@example.com or 703-591-2220.
FDA Issues Two Recalls: Surgical Gowns, Compounded Products for Axia Pharmaceuticals
This week, the FDA issued two recalls that may affect ophthalmologists.
- Surgical gowns and packs by Cardinal Health; potential quality issues affecting some of its Level 3 surgical gowns and accompanying PreSource procedural packs. Customers should immediately discontinue use of all affected surgical gowns and PreSource procedural packs that include the surgical gowns because the manufacturer cannot provide assurance the products are sterile. Customers with questions about whether their own inventory is affected should contact Cardinal Health directly. Visit the FDA website for more information.
- All sterile drug products within expiry by AXIA Pharmaceutical due to a lack of assurance of sterility. AXIA Pharmaceutical is voluntarily recalling all unused sterile drug products within expiry due to a lack of assurance of sterility. The recalled sterile products have been found to be inconsistent with federal guidelines. Administration of a drug product intended to be sterile that is not sterile could result in serious infections which may be life-threatening. To date, AXIA Pharmaceutical has not received any reports of adverse events related to this recall and is recalling all sterile products out of an abundance of caution. Click here for a full list of recalled products. Additional information is available on the FDA website.
If you have any additional questions, please contact Jillian Winans, regulatory affairs specialist, at firstname.lastname@example.org or 703-591-2220.
Advanced APM Participants: If You Have Not Received Your 2019 Bonus Payment, CMS Requests Banking Information by February 28
In late 2019, CMS began distributing Advanced Alternative Payment Model (APM) 5% bonus payments to physicians who met the participation thresholds in performance year 2017. While most APM participants have received their lump-sum bonus payments, CMS was unable to provide some physicians with the payment because it did not have their banking information. CMS is requesting that any Advanced APM participant who did not receive their 2019 bonus payment to contact CMS and provide banking information by February 28, 2020. CMS has provided an instruction sheet and list of participants with outstanding bonus payments. If you need additional information, please contact Allison Madson, manager of regulatory affairs, at email@example.com.
CMS Opens 2019 MIPS Submission Portal; Data Must Be Submitted by March 31, 2020
This week, CMS opened the submission portal for 2019 MIPS data. Eligible clinicians have until March 31, 2020 to submit 2019 performance data that will impact 2021 payments.
Please note: If you are using a third-party vendor to submit MIPS data, such as the IRIS Registry, you do not need to submit data through the CMS portal. Once data has been submitted on your behalf by the third party, you can log in to the CMS portal to review it. In addition, third-party vendors may have alternative deadlines to complete data entry. Please consult with your vendors for specific details.
Logging into the CMS QPP Portal
To sign in and submit data, clinicians will need to register in the HCQIS Authorization Roles and Profile (HARP) system. For clinicians who need help enrolling with HARP, please refer to the QPP Access User Guide.
ASCRS ASOA Resources
ASCRS and ASOA members continue to have full access to the MACRA Center, which includes both 2019 and 2020 MIPS information. If you need additional assistance, please contact Allison Madson, manager of regulatory affairs, at firstname.lastname@example.org or 703-591-2220.
Advocate for Your Patients and Profession; Attend the 2020 Alliance of Specialty Medicine Legislative Fly-In in Washington, D.C. June 15-17
YES Members Should Apply for the Annual Legislative Fly-In Scholarship
ASCRS ASOA members are encouraged to attend the 2020 Alliance of Specialty Medicine Fly-In, which will be held June 15–17 in Washington, D.C. ASCRS and ASOA members who attend the Fly-In will receive in-depth training on policy issues important to ophthalmology and the specialty medicine community—and will have the opportunity to meet with their Representative and Senators to lobby for those legislative issues. Your participation in this event has a direct, positive impact on your profession and patients!
Not familiar with the Fly-In? See what past attendees have to say about the experience in this brief video.
Because of its increased popularity and the rising costs associated with the Fly-In, we will reimburse up to $1,000 in travel expenses. The complete agenda is still being developed, but attendees are asked to arrive in Washington by Monday afternoon, June 15, and not to depart until Wednesday afternoon, June 17, following conclusion of the conference.
If you are interested in attending the 2020 Fly-In, please complete this form at your earliest convenience. We understand that you need advanced notice to arrange your schedule, so you will be notified ASAP when your participation is confirmed and provided with additional details to make your travel arrangements. Keep your eye on the Washington Watch for more information.
YES Fly-In Scholarship
ASCRS and Young Eye Surgeons (YES) are pleased to announce the return of the ASCRS/YES Legislative Fly-In Scholarship Program to encourage U.S. resident and fellow members to attend the Fly-In.
Five applicants will be chosen to receive a full scholarship (registration, travel, hotel accommodations, and meals) to join their peers in the nation’s capital and meet with their members of Congress to advocate for policies that will impact their careers and help their patients. This event not only helps residents and fellows develop their understanding of policy issues, but it provides an opportunity to network with established members and ASCRS leadership. For more information and to apply online, please click here. The application deadline is March 31, 2020.
Any questions regarding the Fly-In or YES scholarships may be directed to Allison Madson, manager of regulatory affairs, at email@example.com or 703-591-2220.