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Ophthalmology Management

Article

Advocacy Pays Off for ASCs

OOSS Washington counsel Michael Romansky, JD, shared key achievements at the organization’s symposium.

By: Jennifer Ford, content director
Ophthalmology Management May 1, 2026 Vol 30, Issue The Ophthalmic ASC May 2026 Page(s): 13-14

Clinical Report: Advocacy Pays Off for ASCs

Overview

Recent advocacy efforts have led to a 3.4% increase in ASC payments for 2026, translating to approximately $150 million for cataract surgeries. Continued engagement with CMS is crucial for addressing reimbursement and regulatory challenges faced by ophthalmic ASCs.

Background

The financial sustainability of ambulatory surgery centers (ASCs) is critical for maintaining access to ophthalmic surgical care. Advocacy efforts play a significant role in shaping reimbursement policies and ensuring that ASCs can provide high-quality services. Recent developments highlight the importance of stakeholder engagement in influencing policy outcomes.

Data Highlights

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Key Findings

  • CMS proposed a 4.7% reduction in ASC payments for 2026, which was reversed to a 3.4% increase after advocacy efforts.
  • This increase is estimated to provide an additional $150 million for ASCs performing cataract surgery.
  • CMS will determine the update factor for ASCs in 2027, with recommendations to retain the Hospital Market Basket.
  • Advocacy is ongoing for a broader interpretation of separate payment for non-opioid drugs used during surgery.
  • Compliance with CMS prior-authorization is essential to avoid non-payment risks for ASCs.
  • OOSS is advocating for enhanced reimbursement for retina procedures due to increasing demand.

Clinical Implications

Healthcare professionals should remain informed about reimbursement changes and actively participate in advocacy efforts to influence policy decisions. Engaging with legislators can help ensure that ASCs continue to receive appropriate funding and support for surgical procedures.

Conclusion

The recent successes in ASC reimbursement underscore the effectiveness of advocacy in shaping healthcare policy. Ongoing engagement is essential to address future challenges and maintain access to quality ophthalmic care.

References

  1. Michael A. Romansky, JD, Ophthalmology Management, 2026 -- Advocacy Leads to Positive Changes in ASC Reimbursement in 2026
  2. Ophthalmology Management -- Eye on OOSS: Advocacy Matters, and It Works
  3. The ASCO Post -- ASCO Advocate of the Year Stresses Importance of Congressional Advocacy on ASCO in Action Podcast
  4. The ASCO Post -- ASCO and Medicaid: Advocacy In Action
  5. CDC Guidelines on Infection Control
  6. INTEGRITY Study - PubMed
  7. Unplanned Hospital Admissions After Surgery - PMC
  8. Accessible version: https://www.cdc.gov/infection-control/hcp/disinfection-and-sterilization/index.html