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CMS Ruling for Toric IOLs

The Centers for Medicare and Medicaid Services (CMS) published Ruling No. CMS-1536-R allowing beneficiaries to choose implantation of an intraocular lens that corrects pre-existing astigmatism at the time of cataract surgery. The January 22, 2007 ruling closely follows the ideas and rationale contained in an earlier CMS Ruling for presbyopia-correcting IOLs. In both rulings, Medicare provides coverage for conventional cataract surgery and permits the beneficiary to pay for non-covered items and services associated with refractive errors. This is welcome news for patients and health care providers.

This ruling affords beneficiaries additional options when deciding with their surgeon which intraocular lens best suits their needs. Patients and physicians may now select a lens to meet post-surgical expectations relating to dependency on corrective eyewear. The astigmatism-correcting IOL (i.e., Alcon AcrySof Toric IOL and the STAAR TORIC IOL) reduces or eliminates pre-existing astigmatism at the time of cataract surgery providing reduced dependency on glasses or contact lenses.

Beneficiaries desire access to new technology and this CMS ruling provides that opportunity. CMS indicates additional guidance will be provided to Medicare contractors.

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