ASCRS Joins Surgical Coalition in Continuing the Push for Increases to Post-Op Visits included in 10- and 90-Day Global Surgical Codes.
Despite support from the AMA, the surgical community, and the majority of the medical community to increase the E/M post op visit values included in 10- and 90-day global surgical services, CMS did not make any changes to the valuation indicating their continuing effort to collect and analyze data on the number and level of office/outpatient E/M visits that are being performed as part of these services. However, CMS did propose increases to the values of other bundled services that are comparable or include E/M visits such as maternity care, emergency department visits, annual wellness visits, among others.
In continuing to fight this decision, ASCRS joined the Surgical Coalition in a letter to CMS pushing for these increases. ASCRS and the Surgical Coalition also continue to lobby Congress to prevent the proposed 2021 cuts, as well as mandate that CMS apply the E/M stand-alone code increases to the 10- and 90-day global surgical procedure codes.
Please Take This Opportunity to Contact Your Members of Congress and Help Us Prevent Drastic Medicare Physician Fee Cuts to Ophthalmology; Use the ASCRS Grassroots Action Center to Send a Letter
As we have reported, the Centers for Medicare and Medicaid Services (CMS) recently released its proposed 2021 Medicare Physician Fee Schedule rule. As a result of the restructuring and revaluing of Evaluation and Management (E/M) codes and other payment changes, in addition to CMS refusing to increase the post-op E/M visits in 10- and 90-day global surgical codes, ophthalmology is expected to get a 6% reduction in overall reimbursement effective January 1, 2021. This is despite the objections and warnings from ASCRS and the medical specialty community on the impact this would have on physician practices already struggling from the negative impacts of the COVID-19 pandemic.
For CMS to offset this increased spending and due to budget neutrality rules, the conversion factor will be reduced by 10.6% – a $3.83 decrease from the 2020 conversion factor. Therefore, the estimated conversation factor for 2021 will be $32.26, the lowest it has been since 1993.
The impact of this and other changes results in a significant reduction to cataract surgery reimbursement (66984) by 9% from the 2020 rate of $557.58 to $505.84. Other ophthalmic codes are also negatively impacted. These cuts will have a devasting impact on ophthalmology and have the potential to reduce patients’ access to surgical care. An excel spreadsheet comparing all CPT code CY 2020 RVUs to the proposed CY 2021 RVUs for your reference is included here.
To prevent these drastic payment cuts and preserve access to care for patients, Congress must act!
ASCRS is working with the Surgical Coalition to pressure Congress to:
- Waive Medicare’s budget neutrality requirements, which allow the implementation of the payment increases for the stand-alone E/M services and the establishment of add-on codes but avoid the reimbursement cuts to other physician services required to offset these costs.
- Require CMS to apply the increased E/M payment to the post-op visits included in the 10- and 90-day global surgical services.
To help us to get Congress to act, it is imperative that members of Congress hear from you! They need to hear how the proposed 2021 Medicare Physician Fee Schedule Rule jeopardizes patient care and threatens the continued viability of your practice.
Act Now to Support Our Efforts.
- Call Your Members of Congress Today!
- Urge your representatives and senators to preserve patient access to surgical care and stop drastic payments cuts for surgical services.
- Call 202-224-3121 and ask to be connected to your elected officials’ offices.
- Use our talking points to incorporate in your discussions
- Use the ASCRS eye Contact Grassroots Advocacy Tool to tell your elected officials to act to prevent Medicare physician reimbursement cuts for surgical services.
Please see the instructions below:
1. Click on the link to take you to the action center:
2. Search to see if you are in the system by entering in your email and zip code. If the system finds you, jump to step #4.
3. If you are not in the system, it will say “Individual not found” and you will need to provide your information for the action center to find your legislator.
Once you’ve created a profile, your name will appear in the top left, and you are able to click through to the alert.
4. Now that you are in the alert, the letter to your members of Congress will appear on the right side. You can then scroll down to the bottom of the letter and edit the letter or click send to send it on to your legislators by clicking “Send All.”
ASCRS Joins Medical Community in Supporting Legislation to Eliminate Provider Relief Fund Tax Penalties
On August 25, ASCRS joined the medical community in sending a letter of support for H.R. 7819/S.4525, the “Eliminating the Provider Relief Fund Tax Penalties Act of 2020,” to Senator Marsha Blackburn (R-TN) and Representatives Cindy Axne (D-IA) and Neal Dunn (R-FL). The legislation would ensure that healthcare providers, regardless of taxpaying status, would not be subject to taxes on payments received from the Provider Relief Fund and that expenses attributable to the Provider Relief Fund are tax deductible.
Contact Lens Rule Changes Go into Effect on October 16, 2020
Last week, the Federal Trade Commission (FTC) published the Contact Lens Final Rule in the Federal Register that implements amendments with new requirements, which are effective on October 16, 2020. Prescribing eye care practitioners are now required to obtain a confirmation of prescription release from patients after releasing a contact lens prescription and maintain the acknowledgment for a period of not less than three years. Prescribers may comply with automatic prescription release via electronic delivery in certain circumstances. If a patient refuses to sign a confirmation, prescribers must note this and save it to record their compliance.
After a contact lens fitting, prescribers will be required to do one of the following to confirm that a patient received their prescription:
- request that the patient acknowledge receipt of the contact lens prescription by signing a separate confirmation statement;
- request that the patient sign a prescriber-retained copy of the prescription that contains a statement confirming the patient has received it;
- request that the patient sign a prescriber-retained copy of the sales receipt for the examination that contains a statement confirming the patient received the prescription; or
- provide the patient with a digital copy of the prescription, and retain evidence that it was sent, received, or made accessible, downloadable, and printable.
The Final Rule also will affect prescribers in several other ways. First, it adds a new definition of the term “provide to the patient a copy,” which will allow the prescriber—with the patient’s verifiable consent—to provide the patient with a digital copy of the prescription instead of a paper copy. When seeking a patient’s consent, prescribers must tell the patient the specific method of electronic delivery they will use and must keep a record of the patient’s consent to that method for three years. The Final Rule will also require prescribers to provide patients or their designated agents with an additional copy of their prescriptions on request within 40 business hours.
The FTC has posted FAQs here.
HHS Extends Provider Relief Fund Application Deadline to September 13
The U.S. Department of Health and Human Services (HHS) has extended the deadline to apply for the Medicaid/CHIP/Dental Relief Fund Distribution, as well as for Medicare providers who missed the opportunity to apply for additional funding from the Provider Relief Fund, to September 13th. In addition, information on the reporting requirements has now been delayed, but according to the agency, this information will be released well in advance of the reporting system being available on October 1st.
HHS recently released a simplified application for provider relief funding, which can be found here.
There are instructions here.
Visit the HHS Provider Relief Website here.