HCFA backs off on ew cataract rules
A controversial proposal to toughen medical necessity guidelines on Medicare cataract surgeries apparently has fizzled out a year after it was introduced by the Health Care Financing Administration (HCFA).
In a letter to the American Academy of Ophthalmology (AAO) in Washington, DC, HCFA said it was withdrawing proposed rules covering the surgeries in order to re-evaluate "new evidence" on the subject before revising national policy. Some officials within the AAO believe the agency caved in under intense opposition to the rules from physicians.
The rules called for stiff documentation requirements aimed at curbing unnecessary cataract removals. Providers who failed to explicitly document the need for the surgery in accordance with specific guidelines could have jeopardized their Medicare payments.
The proposal was first published in the Oct. 6, 1995, Federal Register and required that providers show written proof of patient consent, evidence that corrective lenses would not be a suitable remedy, and a statement that the patient’s health and lifestyle would not be compromised by undergoing the procedure.
HCFA left open the possibility of reintroducing the rule in the future.
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