Prior to the final vote, AOA
president, David A. Cockrell,
OD, (l) AOA discussed
optometry’s role in Medicare
with U.S. Senator John
Tester (D-MT).

WASHINGTON, D.C.—The U.S. Senate approved a $145 billion health care reform bill (H.R.2) on Tuesday, April 14, 2015, that includes a permanent repeal of the Medicare Sustainable Growth Rate (SGR). This eliminates the 21 percent cut in Medicare physician payments that went into effect on April 1. Congress had already approved the bill in late March, but the Senate delayed its decision until after the recent two-week spring recess that ended Monday, as reported by VMail.

The SGR was originally enacted by Congress in 1997 to control Medicare costs, but since 2003 legislators enacted an annual “doc fix” to delay cuts each year. This bipartisan bill replaces the SGR with a new Merit-Based Incentive Payment System that will focus on “quality, value and accountability,” creating alternative payment models to do so. It removes the threat of cuts to Medicare and replaces the SGR with an annual automatic payment increase of 0.5 percent each year over the next five years.

The American Optometric Association (AOA) was present in force at Capitol Hill the day of the Senate vote earlier this week, participating in the 2015 Congressional Advocacy Conference. In a statement the AOA shared with VMail the day after the Senate vote, AOA president David A. Cockrell, OD, said, "It's fitting that there were more than 500 AOA doctors and students on Capitol Hill yesterday in the hours leading up to the historic final vote. We reminded senators about optometry's essential and expanding role in Medicare and kept OD physician status as a non-negotiable foundation of the final bill.”

Following the bill’s passage, Rodney Peele, AOA's chief regulatory counsel, suggested, "AOA recommends holding claims, if practical, until CMS and its contractors announce they are ready to process claims at the new, higher rates. We expect the Medicare contractors will be able to process claims at new rates within a week, but the transition might have some bugs. Keep in mind that CMS will not pay claims until 14 days after they are submitted.”