At the Request of ASCRS and AAO, Senator Rand Paul, MD, Sends Letter to CMS Administrator Highlighting ASCRS and AAO Concerns With Cataract Surgery Prior Authorization Policies in Medicare Advantage Plans; Expresses His Shared Concerns Regarding Delay of Care and the Impact on Patients
On Wednesday, October 6, Senator Rand Paul, MD (R-KY), at the request of ASCRS and the American Academy of Ophthalmology (AAO), sent a letter to CMS Administrator Chiquita Brooks-LaSure, sharing his concerns, as well as ASCRS’ and AAO’s concern over prior authorization policies for cataract surgery in Medicare Advantage (MA) plans.
ASCRS and AAO had reached out to Senator Paul and Representative Mariannette Miller-Meeks, MD (R-IA), expressing concerns, both verbally and written, over Aetna’s newly implemented prior authorization policy for cataract surgery in MA plans that delays patient access. Senator Paul forwarded ASCRS’ and AAO’s letter to the CMS Administrator that outlines the problems our members have encountered with Aetna’s new prior authorization policy including, portal issues, lack of education on policy among insurer employees, poorly designed questionnaire that omits glare/contrast sensitivity testing, and “peer-to-peer” reviews with non-ophthalmologists. Additionally, in the ASCRS/AAO letter, we call on the need for increased oversight of MA plans to ensure they are not inappropriately delaying or denying beneficiaries’ access to medically necessary cataract surgery. In the letter to CMS, Senator Paul noted that, as an ophthalmologist, he shared our concerns and asked CMS to consider our request for increased oversight. Representative Mariannette Miller-Meeks has indicated that she also shares our concerns and will be sending a separate letter to CMS.