Members of the Subcommittee highlighted several ACS advocacy priorities:
- Reforming budget-neutrality requirements in the Medicare Physician Fee Schedule (MPFS)
- Implementing an inflationary update to physician reimbursement
- Reducing burdensome quality measure requirements
Although this hearing cast a meaningful spotlight on the need for long-term physician payment system reform, the ACS remains concerned that the repeated redistribution of resources away from specialized care and toward primary care will continue to unfairly devalue surgical services. Congress should ensure that future reform discussions include all physician specialties, and the ACS remains committed to working with physician leaders in Congress to advance solutions to these challenges.
“Patients need both primary care and timely access to surgical expertise,” Dr. Turner said. “This is not an artificial choice between the two. Any reform effort must strengthen the entire continuum of care without undermining access to specialty and surgical services.”
In the ACS statement for the record (see both the summary and full statement), Congress is urged to:
- Stop the 2.5% efficiency adjustment to work RVUs enacted in 2026 by passing the Efficiency Adjustment Delay Act (HR 7520) and address future pending cuts.
- Implement an update mechanism in the MPFS to account for inflation. This will create a stable base from which physicians can make the leap to value-based alternative payment models (APMs).
- Eliminate the MPFS budget neutrality requirement or increase the trigger threshold and index it annually to account for inflation (see article later in this issue for more).
- Direct the Centers for Medicare & Medicaid Services to partner with stakeholders to test physician-developed APMs, such as those recommended previously by the Physician-Focused Payment Model Technical Advisory Committee.
- Create flexibility for shared measurement and accountability in the Merit-Based Incentive Payment System, such as through expansion of facility-based scoring.
The ACS reinforces its advocacy through broader evidence-based policy analysis and outreach beyond the surgical community. Earlier this month, ACS leaders authored a Health Affairs Forefront article examining Medicare physician payment reform proposals and warning that continued redistribution under budget neutrality risks limiting access to specialty and surgical care without clear evidence of improved outcomes.
Learn more about this critical topic on the ACS Medicare Physician Payment Reform web page.
The ACS continues working with Congress to address policies affecting our Fellows, including the 2.5% "efficiency" cut enacted this year. Your support is essential to help advance these priorities.
Visit SurgeonsVoice to urge your representatives to support HR 7520, the Efficiency Adjustment Delay Act, and restore the full value of surgical work.
Medicare Budget Neutrality Bill Advances Out of Committee
On May 21, the House Ways and Means Committee advanced HR 8163, the Provider Reimbursement Stability Act of 2026, out of committee. This critical legislation would increase the budget neutrality threshold in the Medicare Physician Fee Schedule (MPFS), which has not been updated since 1992, and requires annual indexing to inflation.
Currently, any changes to the MPFS expected to increase expenditures by as little as $20 million annually result in across-the-board cuts. Updating the trigger for budget neutrality adjustments would help to ensure that comparatively minor changes to relative values or the addition of limited new service codes do not always require these across-the-board cuts. The ACS has supported this legislation through multiple iterations and Congressional sessions and is pleased to see it progress.
During discussion of the legislation, the lead sponsor of the Efficiency Adjustment Delay Act (HR 7520) (introduced in February) Rep. Ron Estes (R-KS) reiterated the importance of ensuring all physicians are reimbursed adequately, especially in light of the recently implemented efficiency adjustment.
The ACS is grateful to Rep. Greg Murphy, MD, FACS, for his dedication to creating meaningful long-term reform to the Medicare reimbursement system and to the House Ways and Means Committee for moving this bill forward in the process.
As the bill advances through the legislative process, it is vital that surgeons voice their support early and often, and SurgeonsVoice makes acting simple.
On the Hill
Surgical Access Legislation Is Introduced in Senate
Senators Brian Schatz (D-HI) and John Barrasso, MD (R-WY), introduced the Ensuring Access to General Surgery Act of 2026, which would direct the Health Resources Services Administration to study and define a general surgery workforce shortage area and to collect data on the adequacy of access to surgical services. Additionally, this legislation would grant the Health and Human Services Secretary the authority to create a general surgery shortage area designation. This bill is a companion to the House legislation (HR 7198) introduced earlier this year.
Unlike other key providers, general surgeons do not currently have a formal workforce shortage area designation. Determining where patients lack access to surgical services and designating a formal surgical shortage area would provide a valuable new tool for increasing access to a full spectrum of high-quality healthcare services.
Additionally, incentivizing general surgeons to locate or remain in communities with workforce shortages is essential in guaranteeing that all patients have access to quality surgical care.
Urge your representatives to support the Ensuring Access to General Surgery Act by visiting SurgeonsVoice today.
Prior Authorization Legislation Nears Key Milestone
The ACS continues to fight against overly burdensome prior authorization requirements by advocating for the passage of the Improving Seniors’ Timely Access to Care Act and engaging with Congress on various other prior authorization concerns.
The Improving Seniors’ Timely Access to Care Act (HR 3514/S 1816) currently has 283 cosponsors in the House and 70 in the Senate. This large number of bipartisan cosponsors in both chambers tees up the bill for passage on the House Suspension Calendar, if not included in a large package.
The House Suspension Calendar is a fast-track process the US House of Representatives uses to quickly pass bills that are considered relatively noncontroversial and broadly supported by both parties. The Seniors’ Act is a zero-cost, bipartisan bill that will help streamline prior authorization in Medicare Advantage plans.
As Congress continues to highlight concerns about healthcare affordability, lawmakers and key stakeholders are raising prior authorization reform as part of the broader health policy discussion. Take action to tell your representative to support the Seniors' Act.
State Affairs
California ACS Chapters Advocate for Surgery Priorities
Members of the three California ACS Chapters joined the California Medical Association (CMA) in Sacramento on April 6, where more than 400 physicians, residents, and medical students convened for the CMA’s annual Legislative Advocacy Day. This event provides an opportunity for stakeholders to directly engage with lawmakers on issues affecting patient care and the practice of medicine.
California surgeons (all MD, FACS) Sigrid Burress, John Maa, John Lam, Peter Bretan, Steven Chen, and Timothy Browder participated, bringing frontline clinical perspectives to legislative discussions.
Keynote speaker Monique Limón, Senate President pro Tempore, highlighted ongoing challenges in healthcare access and affordability. Referencing federal policy changes from the passage of HR 1, she noted funding reductions are already impacting patients, stating, “People are losing coverage.”
CMA President René Bravo, MD, encouraged attendees to see advocacy as an extension of their professional responsibility. “Our voices are important, not just because we know healthcare but because we have critical thinking skills that are needed in the legislative arena right now,” he said.
Following a policy briefing, attendees were given their legislator assignments and the bills to discuss, including:
- Support for e-bike safety standards to address rising rates of severe trauma injuries (AB 2346)
- Support prohibiting automatic downcoding by insurers without appropriate clinical review (AB 2431)
- Support addressing the deceptive use of artificial intelligence to impersonate physicians to spread medical misinformation (SB 1146)
- Oppose expansion of naturopathic scope to include prescribing controlled substances and performing certain surgical procedures (SB 1333)
Legislative meetings were coordinated based on Fellows’ practice locations, enabling direct engagement with their elected officials. Participants met with multiple legislators, including Assemblymembers Avelino Valencia (D), Phillip Chen (R), Sharon Quirk-Silva (D), and Kate Sanchez (R), as well as Senators Steven Choi, PhD (R), and Tony Strickland (R).
Throughout the day, physicians emphasized a consistent message: Engagement in the legislative process is essential to protecting patients and strengthening the healthcare workforce.
Advocacy Day provides an important opportunity for lawmakers to hear directly from physicians, helping inform policy decisions that affect patient care. For many participants, the experience underscored the importance of engagement beyond the clinical setting.
