April 4, 2018 -- Volume 7, Number 14
WellCare will Reprocess Denied Vitrectomy Claims
 
 Last week, ASRS confirmed that WellCare will reprocess previously denied vitrectomy claims and continue to pay for vitrectomies as they had prior to CMS's January 18, 2018 Change Request (CR) 10318, Transmittal Request (TR) 2005.
 
While Medicare Administrative Contractors (MACs) were instructed by CMS in February to process related claims during their review of the deletions to Vitrectomy NCD 80.11, ASRS heard from members that commercial insurers were not directly informed of the CMS instruction and were using TR 2005 as a premise for vitrectomy denials. In response, the Society alerted the following entities to CMS’s instruction to suspend vitrectomy denials: Aetna, Humana, UnitedHealthcare (UHC), HealthNet, WellCare, Health Alliance Plan, Triple S, Constellation, MSC Healthcare and Medicare & Mucho Mas (MMM).
 
So far, Aetna, Humana, UHC and WellCare have confirmed that they will proactively adjust previously denied claims until CMS makes its final decision regarding codes it deleted from the NCD.  If you continue to experience vitrectomy denials and would like ASRS to assist you in appealing, or if you have questions about the Vitrectomy NCD 80.11, please contact  monica.horton@asrs.org .
ARSR Opposes Step Therapy and Preauthorization Policies in Oregon and Tennessee

This week, the ASRS sent letters to Blue Cross and Blue Shield of Tennessee and Providence Health Plans  to oppose policies that require physicians to use Avastin first. Such tiered-therapy policies are increasingly being used by health plans to control drug costs. ASRS continues to fight these rules to ensure that retina specialists are able to make wise and judicious choices that are efficacious for patients. If you are subject to step therapy or burdensome prior authorization directives, please contact Monica Horton at monica.horton@asrs.org  with the plan name, policy language and any details about the impact to your practice.
Upcoming Webinar: Retinal Coding 101 (AKA The Source of Gray Hairs)
 
Mark your calendars for the second installment in the 2018 ASRS webinar series. Join us on Thursday, April 19, 2018 at 7:30 PM (CT) for "Retinal Coding 101 (AKA the Source of Gray Hairs)," presented by Ankoor R. Shah, MD, and hosted by Mrinali Gupta, MD, and Aravinda K. Rao, MD. CME credit will be offered.
 
This webinar is part of a series designed by the ASRS Fellowship Directors Section to help supplement fellowship training curricula. This expert-led educational webinar is open to all ASRS members. Register now >>

MEDICAL EDUCATION CREDITS
The American Society of Retina Specialists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The American Society of Retina Specialists designates this live activity for a maximum of 1.0  AMA PRA Category 1 Credits ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Open Payments Data Review is from April 1– May 15
 
From now until May 15, 2018 physicians can review, affirm and dispute their 2017 Program Year Open Payments data.   Physicians and teaching hospitals must initiate any disputes during this review period in order for the disputes to be addressed before they are published in the June 30, 2018 data publication. To access your information, go to the  CMS Enterprise Portal .
Submit Your Latest Work to JVRD

We hope you're enjoying the March/April issue of the  Journal of VitreoRetinal Diseases . Consider publishing your next paper in JVRD for rigorous peer review of your research, prompt publishing and exclusive access to our global retina readership.

Judges Needed for the 20th Annual Film Festival

The ASRS is searching for enthusiastic retina specialists who have a passion for the creative side of medical and surgical education to serve as volunteer judges for the ASRS 20th Annual Film Festival. The Film Festival showcases the observational skills, innovation, and creativity of our members at the ASRS Annual Meeting. 
 
Member candidates interested in serving as Film Festival judges are not required to have knowledge of filmmaking or to be present during the Film Festival showcase. Interested candidates should expect to:

  • Dedicate approximately 2 hours of film viewing/scoring time to grade their film assignments
  • Provide rating scores in overall appeal, clinical value, special effects, production quality, and entertainment

Member candidates who submit a film to the 20th Annual Film Festival are not eligible to serve as judges.
 
If you are interested in serving as a judge for this year's event, please email Chayal Patel no later than April 10.
Follow the ASRS on Social Media
 
Join the growing number of ASRS members who are following the Society on Instagram. Visit   www.instagram.com  -- or better yet, download the free app for your mobile phone, search for  asrs.retinaspecialists  and follow us for quick access to retina images, cases and other clinical and Society updates. And, if you're not already, follow  @asrsdocs  on   Twitter .
Accepting Nominations for the Image of the Year
Submit Nominations for the Retina Image Bank Image of the Year Award.

There are two ways to nominate an image:
For complete details on the eligibility and nomination process visit the  ASRS website . The winner will be recognized at the 36th Annual Meeting

Don't miss the chance to have your images considered for the top prize.  Upload your best images  by April 30 for the chance to be considered. 
Image of the Week
Congratulations to Mehul A. Shah, Shreya Shah, Satyam Gupta, and Romi Singh, from Drashti Netralaya in Dahod, India , w hose image Subhyaloid Hemorrhage has been selected as the Image of the Week. 
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