In Physician Payment Rule, CMS Takes No Action On Office Cataract Surgery – At Least For Now!

In the physician payment rule published today, CMS is silent with respect to taking any further action regarding payment of a facility fee for office cataract surgery.

Every OOSS member is aware that, a year ago, the Centers for Medicare and Medicaid Services (CMS) issued a request for information regarding the advisability of providing a facility fee for cataract surgery performed in the physician’s office.  For OOSS, the response has been swift and clear:  Payment for office cataract surgery is a misguided policy, one that if implemented without adequate regulatory oversight and safeguards, potentially threatens the health and safety of our patients.

OOSS is the only ophthalmology organization to unequivocally oppose the implementation of payment for office cataract surgery.  How have we represented you with respect to this issue?

  • OOSS submitted comprehensive comments to CMS opposing further consideration of payment for cataract surgery, citing the risks to patient health and safety. We urged CMS, before implementing payments for office surgery, to develop standards of care for office facilities that are akin to those applied to ASCs; create a model for regulation and enforcement of such standards; and implement a limited pilot or demonstration project to assess the impact of such a policy on quality of care and patient health and safety.
  • With the Ambulatory Surgery Center Association (ASCA), we met with the agency to further elucidate our concerns.
  • OOSS engaged 170 ophthalmic ASCs in a comorbidity study to disabuse CMS of its view that “it is now possible for cataract surgery to be furnished in an in-office surgical suite, especially for routine cases.” Our finding: “routine” cases are rare and virtually all of our patients present with multiple comorbidities.
  • In addition to the submission of comments by OOSS as an organization, we asked you, our members, to submit comments on your own behalf to CMS. You responded! Of the 110 or so comments submitted to the agency, over 100 opposed the implementation of a program to pay for office cataract surgery.

We are hopeful that CMS’ decision not to press forward with the establishment of payments for office cataract surgery is a final one. Should CMS further proceed in the near or distant term, the OOSS leadership assures you that this is our most important regulatory priority and we will be aggressive and zealous in safeguarding the interests of our patients and our centers.

Should you have any questions, please contact Mike Romansky, our Washington Counsel, at mromansky@OOSS.org.

To review the comments submitted by OOSS to CMS, visit: OOSS/SEE Comments On Office-Surgery

OOSS Symposium 2016@AAO/AAOE Chicago
Saturday, October 15, 2016, 9 am to 4 pm.