Medicare

Withdrawing Eyeglass Coverage Recommended Following Cataract Surgery Gao ID: HRD-90-31 February 8, 1990

Pursuant to a congressional request, GAO examined the issues relating to Medicare reimbursement for cataract surgery.

GAO found that: (1) Medicare regulations defined routine eye care and conventional eyeglasses as refractive corrections to improve the eye's focusing ability; (2) the Health Care Financing Administration (HCFA) considered conventional eyeglasses for those Medicare beneficiaries that had cataract surgery as Medicare-reimbursable prosthetic devices; (3) aged natural lens have impaired near-vision capabilities; (4) Medicare payments for conventional eyeglasses for cataract surgery patients increased from about $60 million in 1985 to about $98 million in 1987; and (5) although GAO recommended in 1984 that HCFA discontinue payments to cataract patients for conventional eyeglasses worn over implanted prosthetic intraocular lenses or over cataract contract lenses, HCFA made no plans for a regulatory change.

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