From the Desk of the AAO: Year-End Spending Bill Addresses Other Academy Priorities
American Academy of Ophthalmology – January 5, 2023
In its last act as the 117th Congress, lawmakers passed an omnibus spending bill that did more than address scheduled physician payment cuts. Along with funding the government programs over the next year the bill also enacts new policies related to health care — including funding for vision research and extending telehealth provisions.
The Academy has analyzed over 4,000 pages of legislative text. Here are other provisions that could affect ophthalmology over the next year.
National Eye Institute and Vision Research Funding
The spending bill included important increases for the National Institutes of Health (NIH) and the National Eye Institute (NEI) that we advocated for in 2022.
The bill provides $47.5 billion for NIH, a $2.5 billion increase over the fiscal year 2022 level, and includes $896.5 million for NEI, an increase of $32.6 million.
Congress also provided $20 million in funding for the Vision Research Program, which is the only dedicated funding source for extramural research into military deployment-related vision trauma.
In keeping with the Academy’s commitment to ensure the highest quality eyecare for military service members and veterans, we have joined the broader vision community to continue to advocate for Vision Research Program funding, and the omnibus legislation maintains the fifth consecutive year of level funding for this important program.
Congress established the program in 2009 to fund effective military-relevant vision research with the potential to significantly improve the health care and well-being of service members, veterans and the public.
It also keeps in place public health emergency waivers, including:
- Allowing the originating site to include any site at which the patient is located, including the patient's home
- Expanding eligible practitioners to furnish telehealth services to include occupational therapist, physical therapist, speech-language pathologist and audiologist
- Extending the ability for federally qualified health centers and rural health clinics to furnish telehealth services
- Providing Medicare Part B coverage and payment for audio-only telehealth services
The Department of Health and Human Services will be required to submit a report to Congress on utilization of services. The interim report is due in October 2024 and the final report in April 2026.
Food and Drug Administration
Although Congress members included a number of Food and Drug Administration (FDA)-related policies in the bill, we were disappointed that they did not include language to restore the longstanding approval process for ophthalmic drugs that we had advocated for.
The Academy had sought legislative language to address a significant change in the FDA’s regulatory framework that no longer allows the agency to regulate products that incorporate a device solely as a drug product. The language would have clarified that any drug packaged in an eye cup, eye dropper or other noninvasive or nonimplanted dispenser is to be regulated as a drug and not a combination product.
Such language was included in S 4348, the Food and Drug Administration Safety and Landmark Advancements Act, which advanced out of the Senate Health, Education, Labor, and Pensions Committee last year.