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

Federal and State Regulatory and Legislative Issues

Practice Protection Committee Hosts Webinar and Updates Resource Document

The American College of Surgeons Practice Protection Committee hosted a webinar Thursday, April 16, outlining the various federal financial resources available to surgeons during the pandemic. Members of the committee also addressed practical suggestions and options to consider in the process of maintaining the viability of their practices during these unprecedented times. The committee anticipates conducting additional webinars in the future.

In addition, the committee’s resource document has been updated to include information about the funds disbursed to surgeons from the Public Health and Social Services Emergency Fund, an additional resource for surgeons who provide telemedicine services, as well as a list of links to medical liability insurance providers outlining alterations in their coverage and payment policies. That document can be found here.

Has Your Governor Issued an Executive Order Regarding Elective Surgery?

A number of state governors and the mayor of the District of Columbia have issued executive orders regarding elective and nonemergent surgery during the COVID-19 outbreak. These orders range from a call to action that providers postpone elective procedures for a period to ensure the availability of personal protective equipment during the crisis with no specified penalties for violations, to orders that warn of imprisonment of violators. View a list of the executive orders, a summary of their mandates, and the dates in which they are in effect here.

Public Health and Social Services Emergency Fund Payments

U.S. Department of Health and Human Services has added $100 billion to the Public Health and Social Services Emergency Fund to be used to support health care-related expenses or lost revenue attributable to COVID-19. Physicians and hospitals started receiving funding from an initial $30 billion disbursement on April 10. These payments are not loans and are not required to be repaid. But in order to keep the funds, recipients must attest that they meet the Terms and Conditions through a portal within 30 days of receiving the funds. Surgeons who believe they are eligible but did not receive a payment should contact UnitedHealth Group’s Provider Relations at 866-569-3522 about eligibility, whether a payment has been issued, and where the payment was sent. Contact regulatory@facs.org with additional questions.  

DEA Declares Exception to 5 Percent Dosage Limit

In order to sustain access to prescription medications in the U.S. during the COVID-19 pandemic, the U.S. Drug Enforcement Administration (DEA) has issued a general exception to the 5 percent limit for dispensing controlled substances.

The exception allows practitioners that are DEA-registered dispensers to distribute limited amounts of controlled substances to another practitioner for distribution to patients. This temporary exception to 21 CFR 1307.11 is in effect until the Secretary of Health and Human Services declares that the public health emergency has ended, unless the DEA specifies an earlier date or otherwise modifies or withdraws this exception. Once this exception expires, practitioners must again comply with the 5 percent rule and all other aspects of 21 CFR 1307.11. The exception does not negate practitioners from continuing to abide by all security, record keeping, and other applicable DEA requirements, especially those related to the distribution of schedule I or II controlled substances.

Liability Protections for Emergency Response: The Network for Public Health Law

The Network for Public Health Law (Western Region Office) has developed an updated document summarizing legal liability protections for emergency medical/public health responses at the federal and state levels.

Texas Chapters Join Texas Medical Association in Calling on Governor to Promote Accountable Care

The Texas Medical Association and several state specialty societies—including the North and South Texas Chapters of the American College of Surgeons—sent a letter to Gov. Greg Abbott (R-TX) April 13, requesting a “multipoint plan to promote accountable care and enhance physician practice viability.”

The letter includes nine requests organized into the following three categories:

  • Across-the-board relief: Implement advanced payment models to provide reliable cash flow to physicians and providers throughout the pandemic
  • Medicaid: Advocate for federal funding to boost Medicaid physician payment rates to Medicare parity
  • Insurance carriers acting as administrators: Encourage insurers to offer self-insured products that remove barriers to COVID-19 treatment and expand availability of telemedicine services

The letter noted an over-reliance on hospital-based and emergency room care that should be reserved for critically ill patients, particularly during the pandemic, and asked for the governor’s assistance in helping Texas physicians in their provision of quality health care.