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Regulatory Relief Advocacy Efforts

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Over the past year, the American College of Surgeons Division of Advocacy and Health Policy (ACS DAHP) has positioned the College at the forefront of the regulatory relief movement through efforts. The ACS is an active participant in all regulatory reform events hosted by the U.S. Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid (CMS). The College also responds to regulatory health care proposals released by federal agencies in order to highlight inherent burdens and to offer recommendations to prevent, reduce, or eliminate such burdens.

In addition, the ACS provides feedback to Congressional and executive branch leaders on the impact of unnecessary regulations on clinical workflow and surgical patient care.

ACS Seeks Fellows’ Feedback on Administrative Burden

The College is actively seeking stories from surgeons about regulations and other administrative requirements that are overburdening their practices. The ACS is particularly interested in Fellows’ input on the 14 categories of administrative burden identified by CMS based on nearly 3,000 comments received from specialty societies, physicians, patients, insurers, and more. These burden categories include:

Documentation: The documentation requirements, such as beneficiary notices, eligibility documentation, and certification of medical necessity

Provider Participation Requirements: The participation requirements, including Conditions of Participation (CoPs), Requirements of Participation (RoPs), and Conditions for Coverage (CfCs)

Alternative Payment Models: The regulatory requirements of shared savings and episode-based payment models

Physician self-referral law (Stark Law) and other fraud and abuse: The burdens related to compliance with the Stark Law and other fraud and abuse laws

Auditing and Claims Denials: The auditing and appeals process, including issues related to contractors and claims denials

Medicare-Adjacent Payment Systems: Comments that fall outside the scope of the Medicare FFS payment rules, such as comments related to Medicare Advantage or Medicaid

Opioid Issues: The opioid epidemic, such as the confidentiality restrictions for substance use disorder data, Prescription Drug Monitoring Programs (PDMPs), and prescribing practices

Payment Policy and Coverage Determinations: The payment and coverage policies, such as billing, coding, MIPS, observation status requirements, and site-neutral payment policies

Quality Measures and Reporting: The quality measurement requirements, including quality reporting programs, cost reporting, public reporting of quality data, and measure coordination across programs

Workforce: The regulations governing staffing and training, supervision requirements, and policies impacting scope of practice

Health Information Technology: The software requirements, interoperability policies, implementation timelines, and regulations governing data sharing

Telehealth: The regulations governing the delivery of telehealth services

Interagency Collaboration: The policies or guidance requiring the involvement of multiple agencies, such as collaboration between CMS and the CDC

Miscellaneous: Comments falling outside of the other burden themes, including comments related to delivery and coordination of care, translation requirements, and the regulatory process in general


ACS Letters to CMS Regarding the Physician Self-Referral Law

The ACS commented on CMS’ Transparency in Coverage proposed rule, through which the agency solicited input on approaches to make health care price information accessible to consumers. In its letter, the College offered guidance to CMS on methods to enhance the usability and accuracy of cost-sharing data presented by private payors to their enrollees.

Read ACS Comments on Physician Self-Referral Law

Read the ACS Letter to OIG on Anti-Kickback Statute

In August 2018, the College sent a letter to CMS Administrator Seema Verma providing input on what exceptions should be created for physician self-referral laws—otherwise known as the Stark Law—to protect care coordination and integration initiatives.

Read the August 2018 letter

 

ACS Participation in U.S. House of Representatives Committee on Ways and Means Regulatory Relief Roundtable

Dr. Patrick Bailey, ACS DAHP Medical Director, participates in the Ways and Means regulatory relief roundtable. On March 15, 2018, the ACS participated in a House Ways and Means Committee roundtable discussion with 9 other healthcare provider groups to address administrative burdens in the Medicare program. The ACS provided feedback on how Congress can improve Medicare so that it works more effectively for both patients and physicians. The College’s recommendations for reducing administrative burdens included: (1) standardizing evaluation and management (E/M) documentation guidelines; (2) eliminating unnecessary and duplicative paperwork and reporting burdens; and (3) improving quality programs to meaningfully measure surgical care.


ACS Submissions to U.S. House of Representatives Committee on Ways and Means, Subcommittee on Health

In August 2017, the Ways and Means Health Subcommittee announced the Medicare Red Tape Relief Project—a Congressional initiative intended to provide relief from the policies that increase health care costs and impede the delivery of high-quality care for Medicare beneficiaries. In response to this initiative, the ACS submitted feedback to the subcommittee on how Congress can work with HHS and CMS officials to reduce physician burden. 

Read the August 2017 feedback

ACS Letter to HHS

In July 2017, the ACS sent a letter to former HHS Secretary Tom Price, MD, asking for his help in easing the increasing administrative and regulatory burdens that surgeons are facing every day.

Read the July 2017 letter

Federal Regulatory Relief Initiatives

CMS' Patients over Paperwork Initiative

CMS launched the Patients over Paperwork initiative, under which agency officials will visit physician practices across the country to gather information on the administrative duties required of health care providers

Learn about Patients over Paperwork


The White HouseExecutive Order 13771

The Trump Administration issued Executive Order 13771, which seeks to “manage the costs associated with the governmental imposition of private expenditures required to comply with Federal regulations.”

Learn about Executive Order 13771

Medicare Red Tape Relief Project

The House Ways and Means Committee established the Medicare Red Tape Relief Project, which encourages physicians to tell Congress what regulations are working and what regulations aren’t.

Learn about the Medicare Red Tape Relief Project