42 C.F.R. § 416.185 Payment review process.
Title 42 - Public Health
(a) CMS publishes a (b) CMS receives a request to review the appropriateness of the payment amount for an IOL. (c) CMS compiles a list of the requests it receives and identifies the IOL manufacturer's name, the model number of the IOL to be reviewed, the interested party or parties that submit requests, and a summary of the interested party's grounds for requesting review of the appropriateness of the IOL payment amount. (d) CMS publishes the list of requests in a (e) CMS reviews the information submitted with the request to review, any timely public comments that are submitted regarding the list of IOLs published in the (f) If CMS determines that a lens is a new technology IOL, CMS establishes a payment adjustment as follows: (1) Before July 16, 2002—$50. (2) After July 16, 2002—$50 or the amount announced through proposed and final rulemaking in connection with ambulatory surgical center services. (g) CMS designates a predominant characteristic of a new technology IOL that both sets it apart from other IOLs and links it with other similar IOLs with the same characteristic to establish a specific subset of new technology within the “class of new technology IOLs.” (h) Within 90 days of the end of the comment period following the (i) Payment adjustments are effective beginning 30 days after the publication of CMS's determinations in the
Title 42: Public Health
PART 416—AMBULATORY SURGICAL SERVICES
Subpart F—Adjustment in Payment Amounts for New Technology Intraocular Lenses Furnished by Ambulatory Surgical Centers
§ 416.185 Payment review process.
