The Academy is leading a campaign for CMS to withdraw its proposal to extend independent diagnostic testing facility (IDTF) status to physician offices. The proposed rule would require all physician offices that wish to provide and receive payment for imaging services to meet regulatory standards, in addition to enrolling as an IDTF by Jan. 1, 2009. Ophthalmic services such as ultrasound, retinal/optic nerve imaging, as well as other eye testing codes, could trigger these certification requirements. For physician practices it means:

• Onsite pre-enrollment carrier inspections;
• Completion of an extensive application process (400-page form);
• Licensing or certification of non-physician personnel to perform diagnostic imaging services; and
• Designation of a supervising physician (in many local carrier jurisdictions only radiologists can provide supervision), who must be proficient in the performance and interpretation of each diagnostic test the IDTF performs.

Under current IDTF requirements, breast and vascular surgeons are not allowed to supervise their own specialized ultrasound services. This could happen to ophthalmic testing even though it is provided by trained eye care professionals 99 percent of the time. This proposal conflicts with a provision in the new Medicare law which exempts ultrasound and x-ray from a new imaging accreditation requirement for facilities.

Ophthalmologists are asked to submit electronic or written comments (the Academy has created a customizable comment template) on letterhead (original and two copies) by Aug. 29 (mail written comments no later than Aug. 22) to:

Centers for Medicare and Medicaid Services
Department of Health and Human Services
Attention: CMS-1403-P
P.O. Box 8013
Baltimore, MD 21244-8013

Your comments have great influence on the final outcome of the rulemaking process. CMS is required to review each comment it receives about proposed provisions. E-mail a copy of your letter to Cherie McNett, Academy health policy director, at cmcnett@aaodc.org, or fax to 202.737.7061.