EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1123870
N Contact information Name: by Title the surgery itself, the facility payment, anesthesia costs, and any separately billable services furnished in the global pe- riod, such as the cost of surgery related to complications. Some measures may include separately payable drugs. In the case of the cataract surgery measure, there is one drug currently on pass-through, injection of phenylephrine and ketorolac (Omidria, Omeros), and several Medicare Part B drugs used postoperatively to treat endophthalmitis. The list of included drugs will be updated on an annual basis. ASCRS and ASOA oppose the inclusion of any drug on pass-through in the episode measure and are advo- cating to have it removed because it defeats the purpose of pass-through to provide separate payment for certain higher-cost new and innovative drugs administered during a surgical procedure and to provide time to introduce the drug into the marketplace. "ASCRS is concerned that in- cluding pass-through drugs in the cost measure could stifle innovation," said Parag Parekh, MD. Following the 3-year pass-through period, CMS mea- sures the drug's utilization, adjusts the facility fee using a formula to account for the drug's cost based on its use and other factors, and bundles the drug into the facility fee. ASCRS and ASOA think including pass-through drugs in the episode measure will inappropriately influence the utilization data for new drugs and are advocating that no pass-through drug be included in the episode measure. "This could end up being penny-wise and pound-foolish for CMS and bad for high quality patient care," Dr. Parekh said. He added, "If a drug given during surgery can reduce the need for medications after surgery, then CMS ought to encourage that. Postop medications can be onerous to pa- tients; they are hard to put in correctly, they are a nuisance for patients and doctors, and they are expensive to the patient and CMS." Cataract episode-based measure attribution Ophthalmologists will be attributed the cataract surgery episode measure if they perform uncomplicated cataract surgery on a Medicare Part B patient during the perfor- mance year. Surgeons must have at least 10 cases that meet the attribution criteria to be attributed and scored on this measure. continued on page 24