News from the AOA's Blog

At the urging of the AOA, the U.S. Centers for Medicare and Medicaid Services (CMS) is now finalizing its plans to more accurately recognize the value of eye care and the practice expenses of ODs as part of a major overhaul of the Medicare physician payment system.  The result will be a $288 million in additional Medicare payments to optometrists between 2010 and 2013 and new recognition for the role of ODs as providers of primary care.   

In 2007, AOA agreed to participate in, design and fund a portion of a survey of physician practice expenses nationwide.  The objective was to be able to provide CMS with the actual data to calculate expenses incurred by ODs serving Medicare beneficiaries and to then allow for a comparison of expense data from the range of other Medicare providers.  With the data from AOA and national medical groups in hand this year, CMS calculated payment changes aimed at correcting inequities in the current system and placing a new focus on the delivery of primary care services.     

More than 100 AOA members – selected at random – completed the detailed survey questions, a very time consuming endeavor.  After the results were submitted, the AOA Washington office’s federal regulatory team and state optometric associations joined together to urge CMS officials to begin using the new data beginning in 2010, which the agency now plans to do through a four-year, phased-in increase in the relative value codes billed by eye doctors.  According to an analysis by the AOA Third Party Center, the Medicare increases could also affect third party payers who rely on the Medicare resource-based relative value scale (RBRVS).

Some medical specialty groups – notably cardiologists and oncologists – face reductions in Medicare payments over the same four-year period.  They’re complaining to CMS and to Congress, and want to overturn the results of the survey.  The AOA is closely monitoring their efforts, and is providing agency officials and key Members of Congress with accurate information in support for the survey and the new payment system.