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Outpatient Ophthalmic Surgery Society, others challenge CMS 2018 payment updates — 5 key recommendations

The Outpatient Ophthalmic Surgery Society partnered with American Society of Cataract and Refractive Surgery, the American Society of Retinal Specialists and Society for Excellence in Eyecare to comment on the CMS proposed 2018 payment rates.


The societies recommended:

1. CMS use the Hospital Market Basket to calculate payment updates instead of the Consumer Price Index. CMS uses the HMB to update hospital outpatient department rates, which typically result in higher adjustments.

2. Separate reimbursement for FDA-approved intracameral drugs under Medicare Part B. Currently, these drugs are included as a covered service with the facility fee.

3. Delay OAS CAHPS implementation, which scores patient experience and satisfaction.

4. Augment ASC reimbursement for procedures that require expensive devices, setting rates at 40 percent of the unadjusted ASC payment rate.

5. Eliminate the agency's prohibition against ASCs billing for services reported with a CPT unlisted surgical code.

The societies also addressed quality reporting requirements in their letter, asking the agency to adopt the proposed measure for ASCs to report on toxic anterior segment syndrome for cataract patients.

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