Advocacy Pays Off for ASCs

At the Outpatient Ophthalmic Surgery Society’s “OOSS Perspective 2026” symposium in Washington, DC, the organization's Washington counsel, Michael Romansky, JD, delivered an update on reimbursement, regulatory developments, and advocacy priorities affecting ophthalmic ambulatory surgery centers (ASCs).

By
Jennifer Ford, content director
Jennifer Ford, content director
May 1, 2026
4 min

Ophthalmology Management

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.