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Outpatient Payment Proposal In Brief

This article was originally published in The Gray Sheet

Executive Summary

Alcon seeks new NTIOL class: CMS says in its 2011 outpatient payment proposal, released July 2, that it is reviewing a request from Alcon Laboratories to establish a new class of new-technology intraocular lenses (NTIOL) for the firm's Acrysof Natural lenses, which use blue light filtering to improve driving safety under glare conditions. CMS notes that in 2004 it considered and rejected a request to create a separate ambulatory surgical center payment class for another intraocular lens based on blue light filtering. The agency seeks public comment on peer reviewed data that would support or disprove Alcon's claims about the device's clinical benefits, especially in the Medicare population. If a new class is created, CMS would pay an extra $50 for five years for each outpatient procedure using the lens. Since 2000, CMS has created three new NTIOL classes, including a class for lenses designed to reduce spherical aberrations to improve visual acuity; four companies with such products will continue to receive a $50 premium through Feb. 26, 2011 (1"The Gray Sheet" March 24, 2008)
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