Regulatory/Legislative News

Medicare will make sweeping changes in how it pays for clinical laboratory tests starting in 2017. The Protecting Access to Medicare Act, enacted April 1, will make the most significant reform of Medicare’s Clinical Laboratory Fee Schedule (CLFS) since its introduction in 1984, by setting CLFS payment amounts based on rates paid for laboratory tests in the private sector.

Individual eligible professionals (EPs) who reported at least one Physician Quality Reporting System (PQRS) quality measure in 2013 via claims-based reports can now view the entire 2013 calendar year of data using the 2013 PQRS Interim Feedback Dashboard. Summary data is available to Taxpayer Identification Number (TIN), and individual detail is provided by National Provider Identifier (NPI). This data will allow EPs to monitor the status of their claims-based measures and measure group reporting.

In what is believed to be the first settlement of its kind, an ophthalmologist recently agreed to resolve a False Claims Act complaint that alleged he performed medically unnecessary laser services to Medicare patients and caused the hospital where the procedures were performed to file false claims, and, therefore, he also should be liable for those claims.

The Score Analyzer, a software algorithm used for the objective screening of the risk of corneal ectasia, has received CE mark in the European Union, Bausch + Lomb announced in a press release. The Score Analyzer provides surgeons an objective evaluation tool for early-stage keratoconus. After an examination with the Orbscan topographer (Bausch + Lomb), the Score software automatically associates the Placido-based keratometric map, anterior and posterior corneal elevation, and corneal thickness profile into one value, according to the release.

On April 1, President Barack Obama signed into law the Protecting Access to Medicare Act of 2014.

Implementation of ICD-10 will be a significant and daunting change for ophthalmology, according to several experts in the field.

Collaboration among physicians, teaching hospitals, and biopharmaceutical and medical device manufacturers contributes to the development and delivery of life-saving products, including treatments that have led to declining death rates over the last few decades for heart disease, stroke, cancer and HIV/AIDS. However, for many years, some government officials and other stakeholders have expressed concern that industry activities involving physicians and teaching hospitals, such as consulting, sponsorships, and industry-supported research, training and education, may result in potential conflicts of interest that may influence physician decision-making and raise health care spending.

The US Senate voted Monday to approve a one-year temporary legislative patch to avoid looming 24% cuts to physician Medicare payments. The measure also delays the ICD-10 billing codes compliance deadline until 2015

In a development that many predicted, federal authorities recently initiated what is likely to be the first of many investigations into a physician-owned distributorship (POD). PODs sell devices for use in procedures at hospitals and ASCs, and many focus on implantable devices, including orthopedic and cardiac devices.

Legislation to avert a March 31 deadline to cut physician Medicare payments by 24% has been scheduled for a Thursday vote in the US House of Representatives. But the measure is another 1-year temporary patch and not a more permanent fix to Medicare’s sustainable growth rate formula.