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All Member Alert
August 2, 2005
Ophthalmology Takes a Hit in Proposed Fee Schedule Rule
An advance copy of the Centers for Medicare and Medicaid Services (CMS) 2006 Proposed Medicare Physician Fee Schedule, obtained by the Academy this week, reflects the anticipated 4.3 percent cut to the conversion factor due to the flawed SGR update formula. In addition, ophthalmology would take an immediate 1.1 percent cut as a result of revisions to practice expense methodology in 2006.
The rule is scheduled to be published Aug. 8 in the Federal Register. Comments on the proposed fee schedule are being accepted until Sept. 30, 2005, with publication of the final rule expected by Nov. 1, 2005.
As you know, the Academy is working with the AMA and others on a legislative change to derail the cuts and fix the SGR. The additional cut expected for specialties such as ophthalmology and thoracic surgery is due to CMS's decision to move from the current "top down" practice expense (PE) methodology to a "bottom up" methodology. Recognizing the dramatic impact this change would have as a result of budget neutrality, CMS proposes a phase-in process, meaning ophthalmology would proceed to a 4 percent cut by 2009. The Academy will meet with CMS to address problems created by its transition to a bottom-up PE methodology.
The Academy is pleased to report that CMS has responded to its request to extend the high-risk glaucoma screening benefit to persons of Hispanic descent age 65 and older because they are identified as a high-risk ethnic group. In addition, CMS responded to Academy comments and corrected malpractice expenses for optometry, which had been erroneously equated to ophthalmology.
Questions regarding the fee schedule should be directed to DeChane L. Dorsey, director of health policy, at [email protected].
August 2, 2005
Ophthalmology Takes a Hit in Proposed Fee Schedule Rule
An advance copy of the Centers for Medicare and Medicaid Services (CMS) 2006 Proposed Medicare Physician Fee Schedule, obtained by the Academy this week, reflects the anticipated 4.3 percent cut to the conversion factor due to the flawed SGR update formula. In addition, ophthalmology would take an immediate 1.1 percent cut as a result of revisions to practice expense methodology in 2006.
The rule is scheduled to be published Aug. 8 in the Federal Register. Comments on the proposed fee schedule are being accepted until Sept. 30, 2005, with publication of the final rule expected by Nov. 1, 2005.
As you know, the Academy is working with the AMA and others on a legislative change to derail the cuts and fix the SGR. The additional cut expected for specialties such as ophthalmology and thoracic surgery is due to CMS's decision to move from the current "top down" practice expense (PE) methodology to a "bottom up" methodology. Recognizing the dramatic impact this change would have as a result of budget neutrality, CMS proposes a phase-in process, meaning ophthalmology would proceed to a 4 percent cut by 2009. The Academy will meet with CMS to address problems created by its transition to a bottom-up PE methodology.
The Academy is pleased to report that CMS has responded to its request to extend the high-risk glaucoma screening benefit to persons of Hispanic descent age 65 and older because they are identified as a high-risk ethnic group. In addition, CMS responded to Academy comments and corrected malpractice expenses for optometry, which had been erroneously equated to ophthalmology.
Questions regarding the fee schedule should be directed to DeChane L. Dorsey, director of health policy, at [email protected].
