American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Federal and State Regulatory and Legislative Issues

Surgical Coalition Offers Recommendations for Next COVID-19 Relief Package

The American College of Surgeons (ACS) and 22 members of the ACS-led Surgical Coalition sent a letter April 13 to the leadership of the U.S. Congress making requests for the next COVID-19 legislative package. Read more about specific points included here.

  • Targeted relief for physicians and their practices through the inclusion of the Immediate Relief for Rural Facilities and Providers Act (H.R. 6365/S. 3559), which will assist in supporting physician-owned small businesses.
  • Refinements to the Medicare Accelerated and Advance Payment Program, specifically lowering the interest rate on balances due at the end of the recoupment period to 0 percent, as well as other necessary changes.
  • Congressional action to provide critical support for practices recovering from the pandemic that are facing substantial payment reductions in the coming months. The Surgical Coalition urged Congress to waive the budget neutrality requirements stipulated in Section 1848(c)(2) of the Social Security Act for the finalized evaluation and management (E/M) code proposal, including increasing the E/M postoperative visits for 10- and 90-day global services for at least five years.
  • Medical liability protections for physicians on the frontlines of treating COVID-19 patients.
  • Student loan relief for physicians who treat COVID-19 patients.
  • Further supply chain support for lifesaving equipment, such as personal protective equipment, including face masks, gowns, N95 respirators, ventilators, and extracorporeal membrane oxygenation.

The ACS will continue to partner with the Surgical Coalition and other physician specialty organizations to ensure Congress receives a united and well-supported message. The timing of the next COVID-19 relief package is unclear at present, but Congress is poised to legislate on the impact of COVID-19 in the coming months.

For more information regarding COVID-19 and congressional legislation, contact Kristin McDonald, Manager of Legislative and Political Affairs, at kmcdonald@facs.org.

CMS Begins Disbursement of Relief Funds

As noted in the lead story of the April 10 issue of the Bulletin: ACS COVID-19 Updates, the Centers for Medicare & Medicaid Services (CMS) has begun disbursing $30 billion in grants directly to providers with no action necessary on the part of providers to receive those funds. The $30 billion in funds disbursed last week is just a portion of the $100 billion Public Health and Social Services Emergency Fund. Payments to providers were deposited into accounts based on Taxpayer Identification Numbers. The payment amount received was calculated based on a percentage of the provider’s 2019 Medicare receipts. The specific announcement including the formula of how much each individual received, how the payments were made, and other details regarding the program can be found here.

CMS Developing Strategies for Targeted Disbursements

In the press release from April 10 noting the beginning of the delivery of the initial $30 billion of relief funds, the Centers for Medicare & Medicaid Services (CMS) stated it was rapidly working on additional targeted distributions. These targeted disbursements will focus on providers in areas particularly impacted by the COVID-19 outbreak, rural providers, providers of services with lower shares of Medicare reimbursement, and those providers who predominantly serve the Medicaid population. That press release can be viewed here. Based on this information, it is anticipated that providers without many receipts from Medicare (such as children’s hospitals, pediatric specialists, obstetricians/gynecologists) will be addressed in subsequent targeted distributions of funding. Details are pending.

Study Shows Projected Economic Impact of COVID-19 Inpatient Stays

COVID-19 is exacting heavy economic and social costs around the world. In the U.S., one area of great concern is the potential cost of inpatient services for patients with the disease. A study by FAIR Health draws on its database of more than 30 billion private health insurance claims, as well as estimates of Medicare and Medicaid costs, to project U.S. costs for COVID-19 patients requiring inpatient care. Estimates are based on International Classification of Diseases, 10th edition (ICD-10) procedure codes and revenue associated with influenza and pneumonia, then, as an alternative, on the basis of diagnosis-related groups (DRGs) associated with pneumonia. The study also examines telehealth codes commonly used for respiratory infections and their costs.