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Medicare Crisis Averted for Now, ODs Expected to See 2012 Pay Increase

January 6, 2012

At the urging of the AOA and others, U.S. House and Senate leaders came together late last year to strike an eleventh-hour deal to avert a more than 27 percent cut to Medicare payments to doctors of optometry and other physicians scheduled to take effect Jan. 1, 2012.

This latest action to forestall scheduled pay cuts means that most physicians will continue to receive 2011 rates for Medicare services they provide through February. Though, as a result of AOA’s ongoing federal advocacy, many optometrists are on track to see even higher payments in 2012.

After convincing the Centers for Medicare and Medicaid Services (CMS) to place a higher relative value on eye care services, AOA now anticipates that many ODs will be paid more for most services than they were last year. In fact, optometrists are expected to see a roughly two percent increase in Medicare payments in 2012, worth $20 million this year alone.

The anticipated increase comes as a result of AOA’s ongoing advocacy in the nation’s capital and could mean that optometry will pass $1 billion in Medicare annual allowed charges for physician services. Of the 56 specialties tracked by CMS, only two will see a larger percent increase than optometry in 2012. Of note, no MD specialty will see as much as a two percent increase in 2012.

AOA advises members that Medicare contractors and carriers will post new payment files by Jan. 11. Optometrists are encouraged to check those local rates for services which they bill.

While increases for the first months of 2012 are on schedule, the anticipated rise for certain Medicare services for the remainder of 2012 could be for naught if Congress fails to take action to avert the next scheduled cut as a result of the year-end deal. Without corrective legislative action, a roughly 27.5 percent Medicare physician payment cut is scheduled to take effect Mar. 1, 2012.

AOA volunteers and staff will continue working with House and Senate leaders to find a lasting and equitable solution to Medicare’s flawed payment formula while at the same time protecting seniors’ access to the essential optometric eye care services that they need and deserve.

To help amplify the AOA’s ongoing federal advocacy efforts, doctors and students are being asked to reach out to their U.S. senators and representatives by logging-in to the AOA’s Online Legislative Action Center at http://www.aoa.org/x4821.xml and take action.

AOA members with questions or concerns should contact the AOA Washington Office at 800-365-2219 or by e-mail at: ImpactWashingtonDC@aoa.org.

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