Eyeworld

EW MEETING REPORTER 172 March 2015 electronic health records (EHR), and the Value-Based Payment Modifier (VBPM) were discussed. In terms of PQRS, eligible professionals must report 9 PQRS measures and must cover at least 3 of the National Qual- ity Strategy (NSQ) domains for 50% of the Medicare Part B fee-for-service patients they see during the report- ing periods to avoid a 2% PQRS pen- alty. There is also no longer a PQRS incentive payment. Additionally, the use of quality performance measures as "standards of care" in medical malpractice claims brought in any court of law would be prohibited. EHRs would be required to be "interoperable" by 2017. Ms. McCann said a common theme in the Medicare bills coming from the House and Senate is that all the proposals are bipartisan and aimed at moving Medicare payment into a system based on outcomes, quality, and efficiencies. The 21st Century Cures Ini- tiative is a bipartisan effort by the House Energy and Commerce Committee to speed access to new drugs and devices. This was a year- long study of the current state of medical innovation. A discussion draft released at the end of January called for increasing flexibility in clinical trials, better integration of patient perspectives, improving data access and sharing, an accelerated approval process for breakthrough devices, an improved process for securing Medicare coverage for new drugs, increased funding for medical research, and incentives for the de- velopment of new drugs and devices for unmet needs. This also included a provision to rescind the elimina- tion of the 10- and 90-day global codes, and CME exemption from the Sunshine Act. The 10- and 90-day global codes are one of the most pressing matters at this time, Ms. McCann said. CMS is going to refine bundles by transi- tioning over several years all 10- and 90-day global codes to 0-day global codes. The postop visits would be eliminated from 10-day global codes in 2017 and from the current 90-day global codes in 2018. This proposal will affect more than 4,200 codes. CMS will most likely create new postop visit codes, which will be reimbursed at a lesser amount than the current E/M or eye codes. "It's also highly likely that they're going to limit the amount of postop visits," she said. If CMS were to use the reverse building block methodology, which would simply back out the existing E&M services associated with that bundle, ophthalmology would be the hardest hit specialty because of its high practice expense costs. These costs are not accounted for in either the surgical fee or the postop visit, but are part of the bundle. Therefore, there would be no way to account for and pay for these prac- tice expense costs. Quality programs including the Physician Quality Reporting Sys- tem (PQRS), electronic prescribing, View videos from Sunday at SideXSide 2015: EWrePlay.org Robert Cionni, MD, Salt Lake City, discusses the benefits of intraoperative aberrometry. Data obtained from aberrometers changes Dr. Cionni's surgical management in the majority of his cases. Reporting from ASCRS•ASOA SideXSide 2015, Aventura, Fla., February 12–15 View videos from Saturday at SideXSide 2015: EWrePlay.org Nancey McCann, director of government relations for ASCRS•ASOA, Fairfax, Va., describes proposed changes to surgical global periods and hopes for reformation of the SGR.

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