ACS Advocacy Brief: November 3

Medicare Payment Cuts

Take Action Today to Prevent Dangerous Medicare Payment Cuts from Taking Effect in January

The 2023 Medicare Physician Fee Schedule final rule, released November 1 by the Centers for Medicare & Medicaid Services (CMS), confirms a nearly 4.5% cut to surgeons and anesthesiologists that will jeopardize patient access for needed surgical care.

“At a bare minimum, Congress must pass HR 8800 to prevent these cuts whose effects would be to harm Americans most in need of care,” said Patricia L. Turner, MD, MBA, FACS, ACS Director and CEO. “Without Congressional action, vulnerable seniors’ nationwide access to timely, high quality, and essential surgical care will be negatively impacted. If allowed to go into effect, these reductions will be yet another blow to an already stressed healthcare system. The ACS has always been willing to work with Congress to find permanent solutions to this issue in the long term, but we must act now to preserve critical access for patients.”

The ACS is a founding member of the Surgical Care Coalition (SSC), an organization dedicated to working with Congress to reform physician reimbursement in the US. Leaders of other SSC member organizations echoed Dr. Turner’s call to action.

Combined with a 4% Medicare payment reduction stemming from the Statutory Pay-As-You-Go Act, surgical care faces cuts of 8.5% in Medicare reimbursement on January 1. Meanwhile, significant medical inflation and staffing and supply chain shortages continue to harm surgical care teams across the country. Without congressional intervention, these drastic cuts will put additional strain on physicians who are already struggling to keep up with the rising cost of delivering care.

Congress must take immediate action protecting patient access to surgical care by passing HR 8800, the Supporting Medicare Providers Act of 2022—and surgeons are critical in these efforts. More than 1,000 surgeons already have used SurgeonsVoice to advocate for congressional action, and you can join the call today.

Take Action: Tell Congress to Stop Medicare Payment Cuts!

Senators Urge Leadership to Reform Medicare Payment System

Shortly after the CMS Medicare cut announcement this week, 46 Senators sent a letter to their leaders, urging them to work on a bipartisan plan that would address the imminent payment cuts. Additionally, the letter, led by Senators Debbie Stabenow (D-MI), John Barrasso, MD (R-WY), Robert Menendez (D-NJ), John Boozman, OD (R-AR), and Roger Marshall, MD (R-KS), expressed support for long-term Medicare payment reforms that operate in a fiscally responsible manner. Earlier today, the Surgical Care Coalition announced their support for the Senate letter.

“As this threat looms near, it is now vital that Congress advance H.R. 8800 to protect those most at risk from the threats posed by the continued withdrawal of investment in surgical care across the country,” said Michael Dalsing, MD, President of the Society for Vascular Surgery.

ACS Responds to Congressional Request for Information on Medicare Payment Reform

Earlier this year, Representatives Ami Bera, MD (D-CA), Larry Bucshon, MD (R-IN), Kim Schrier, MD (D-WA), Michael Burgess, MD (R-TX), Earl Blumenauer (D-OR), Brad Wenstrup, DPM (R-OH), Bradley Schneider (D-IL), and Mariannette Miller-Meeks, MD (R-IA) issued a request for information (RFI) on actions Congress should take to stabilize the Medicare payment system without dramatic increases in Medicare spending, while ensuring successful value-based care incentives are in place.

On October 31, the ACS submitted a response to the RFI that focused on the need for immediate stability in the Medicare physician payment system, suggested improvements to the Medicare Access and CHIP Reauthorization Act (MACRA), ACS efforts that drive quality within the current system, and current barriers to achieving value-based care. The response also proposes specific Congressional action to help address some of the highlighted areas of concern. View the RFI response for more detailed information on ACS proposed solutions.

Advocacy in Action

ACS President E. Christopher Ellison, MD, FACS (left) with Dr. Armstrong and Ross F. Goldberg, MD, FACS, Chair of the ACS Board of Governors Executive Committee

John H. Armstrong, MD, FACS, is 2022 SurgeonsVoice Advocate of the Year

The ACS congratulates the 2022 SurgeonsVoice Advocate of the Year, John H. Armstrong, MD, FACS, a board-certified general surgeon based in Ocala, FL.

The honor was presented during Clinical Congress 2022 at the Annual Business Meeting of Members. Dr. Armstrong was selected based on several criteria, including his unwavering commitment to the College’s advocacy and political efforts. He serves as a member of Health Policy and Advocacy Committee, an Advisory Member of the PAC Board, Legislative Committee Member, and Chair of the Committee on Trauma Advocacy Pillar.

Dr. Armstrong demonstrates superior commitment to advocacy and an understanding of just how critically important it is to continue to educate and engage with lawmakers in Washington, DC, to effect change and leverage’s surgery’s voice on Capitol Hill. Special thanks and congratulations again to Dr. Armstrong.

The following top contenders also were recognized for their outstanding participation:

Daniel Schaefer, MD, FACS

Marion Henry, MD, MPH, FACS, FAAP

James Jeng, MD, FACS

William Kasper, MD, FACS

Krista Kaups, MD, FACS

Mark Dobbertien, MD, FACS

William Kasper, MD, FACS

Steven Schechter, MD, FACS

Nancy Gantt, MD, FACS

Amy E. Liepert, MD, FACS

Charles B. Rodning, MD, FACS

Surgeons Show Support for Advocacy, Political Efforts during Clinical Congress

The ACSPA booth at Clinical Congress 2022

The recent in-person Clinical Congress 2022 provided registrants the opportunity to visit the American College of Surgeons Professional Association’s (ACSPA) information booth, where they learned more about grassroots (SurgeonsVoice) and political (SurgeonsPAC) programs, including how to become more active. Additionally, the booth offered attendees a venue to engage with colleagues and ACS staff, as well as review programs featuring outstanding surgeon advocates, key congressional allies, SurgeonsPAC members, and more.

The meeting generated increased support for advocacy and political action. Specifically, October 16–20, more than 200 in-person and virtual attendees contributed more than $52,000 to SurgeonsPAC. Additionally, SurgeonsPAC hosted and sponsored other engagement opportunities for eligible members and SurgeonsPAC contributors, including a Resident and Associate Society (RAS) networking event, plus a reception and 20th anniversary celebration.

Looking ahead to a new Congress and presidential election cycle, SurgeonsPAC remains an important tool to educate federal lawmakers about challenges facing surgery and surgical patients. For more information, contact Katie Oehmen, Senior Manager, Political and Grassroots Engagement at koehmen@facs.org.

Contributions to ACSPA-SurgeonsPAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of ACSPA have the right to refuse to contribute without reprisal. Federal law prohibits ACSPA-SurgeonsPAC from accepting contributions from foreign nations. By law, if your contributions are made using a personal check or credit card, ACSPA-SurgeonsPAC may only use your contribution to support candidates in federal elections. All corporate contributions to ACSPA-SurgeonsPAC will be used for educational and administrative fees of ACSPA and other activities permissible under federal law. Federal law requires ACSPA-SurgeonsPAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. ACSPA-SurgeonsPAC is a program of the ACSPA, which is exempt from federal income tax under section 501c (6) of the Internal Revenue Code.

SurgeonsPAC Contributors at Clinical Congress 2022

Paul Albini, MD, FACS

Somya Al-Embideen, MD

Edward L. Alexander, MD, FACS

Weston Andrews, MD

Saeed Arefanian, MD

Haad Arif

John H. Armstrong, MD, FACS

Amanda K. Arrington, MD, FACS

Ahad Azimuddin

Yvonne Baerga-Varela, MD, FACS

H. Randolph Bailey, MD, FACS

Jamie N. Bakkum-Gamez, MD, FACS

Linda M. Barney, MD, FACS

Natalia M. Barragan, MD

David E. Beck, MD, FACS

Paul M. Bjordahl, MD, FACS

Stephen A. Bodney, MD, FACS

Mark W. Bowyer, MD, FACS

Karen J. Brasel, MD, FACS

Tamir Bresler, MD

Michelle R. Brownstein, MD, FACS

Robert Brumer, MD

Yusef J. Buti, MD

Patricia M. Byers, MD, FACS

Eric M. Campion, MD, FACS

Michael Cantrell, MD

Jeannette M. Capella, MD, FACS

Robert O. Carpenter, MD, FACS

Carisa Champion, DO

Anthony G. Charles, MBBS, FACS

William C. Cirocco, MD, FACS

Matt Coffron, Staff

David T. Cooke, MD, FACS

Joseph A. Corrado, MD, FACS

Alisa M. Cross, MD, FACS

Ronald L. Dalman, MD, FACS

James Danahey

Brian R. Davis, MD, FACS

Tedd E. Dawson, MD, FACS

Marc A. De Moya, MD, FACS

Noosha Deravi, MD

Anand K. Devaiah, MD, FACS

Heather S. Dolman, MD, FACS

Jonathan M. Dort, MD, FACS

John J. Doski, MD, FACS

Mack D. Drake, DO, FACS

Erik P. Dutson, MD, FACS

Brian J. Eastridge, MD, FACS

Ramsey Elsayed, MD

Brent J. Emigh, MBBCh

Rachael Essig, MD

Courtney Eubanks

Richard A. Falcone, MD, FACS

Jeffrey M. Farma, MD, FACS

Diana L. Farmer, MD, FACS, FRCS

Peter E. Fischer, MD, FACS

James W. Fleshman, MD, FACS, FASCRS

Kyra Folkert, MD

Henri R. Ford, MD, FACS

Elizabeth Franco Cadavid, MD, FACS

Rajesh R. Gandhi, MD, FACS

Alan Garely, MD, FACS

George K. Gillian, MD, FACS

Laura N. Godat, MD, FACS

Jon M. Greif, DO, FACS

Kent Grosh, MD

Seung S. Gwon, MD, FACS

Amy L. Halverson, MD, FACS

Mark E. Hamill, MD, FACS

Alyssa Hammar, DO

Ziad Hanna, MD, FACS

David T. Harrington, MD, FACS

Marion C. W. Henry, MD, FACS

Melissa Red Hoffman, MD, FACS

Eunice Yuee-Dean Huang, MD, FACS

Stuart D. Hurst, MD, FACS

Matthew M. Hutter, MD, MPH, FACS

Thomas Irons, MD

Benjamin T. Jarman, MD, FACS

Aaron R. Jensen, MD, FACS

Jay A. Johannigman, MD, FACS

D'Arcey Johnson

Joslyn Jose, MD

Sudhir Kalaskar, MBBS, FACS

Kelly A. Kapp, MD

Nikolas Kappy, MD, FACS

Krista L. Kaups, MD, MSc, FACS

Katherine Kelley, MD, FACS

Meera Kotagal, MD, FACS

Kate H. Kraft, MD, FACS

Afif N. Kulaylat, MD, FACS

Sean J. Langenfeld, MD, FACS

Anne C. Larkin, MD, FACS

Christine Laronga, MD, FACS

Kathleen A. LaVorgna, MD, FACS

Susan H. Lee, MD, FACS, FACOG

Jason S. Lees, MD, FACS

A. Marilyn Leitch, MD, FACS

John I. Lew, MD, FACS

Joseph R. Lewis, DO

Lillian F. Liao, MD, FACS

Jayme D. Lieberman, MD, FACS

William A. Liston, MD, FACS

Thomas C. Litton, MD, FACS

Lawrence Lottenberg, MD, FACS

Brendan B. Lovasik, MD

Joseph D. Love, DO, FACS

John L. Luckoski, MD

Erica K. Ludi, MD

Dennis P. Lund, MD, FACS

Quan P. Ly, MD, FACS

Daphne P. Ly, MD, FACS

Donald R. Mackay, MB, BCh, FACS

Mark A. Malangoni, MD, FACS

Samuel P. Mandell, MD, FACS

Mary E. Maniscalco-Theberge, MD, FACS

Helen A. Markowski, MD, FACS

Ashley Y. Martin, DO, FACS

Monika Masanam, MD

Viraj Master, MD, FACS

Samer G. Mattar, MBBCh, FACS

Robert A. Mazzoli, MD, FACS

Andrew C. McCoy, MD, FACS

Kristin McDonald

John McNelis, MD, FACS, FCCM

Marcene R. McVay Gillam, MD, FACS

Ingrid M. Meszoely, MD, FACS

Anna N. Miller, MD, FACS

Ian C. S. Mitchell, MD, FACS

Vijay K. Mittal, MD, FACS

Carlos E. Montenegro, MD, FACS

Matthew L. Moorman, MD, FACS

Kenric M. Murayama, MD, MBA, FACS

William L. Newcomb, MD, FACS

Seth L. Newman, MD, FACS

Valentine N. Nfonsam, MD, FACS

Katie Oehmen

Dmitry Oleynikov, MD, FACS

Kris Olson, MD, PhD

Brian C. Organ, MD, FACS

Harry T. Papaconstantinou, MD, FACS

Mayur B. Patel, MD, FACS

Carlos A. Pelaez Gil, MD, FACS

Tony Peregrin

Barbara J. Pettitt, MD, FACS

Susan E. Pories, MD, FACS

Jacob A. Quick, MD, FACS

Zakiur Rahaman, MD

Justin Lee Regner, MD, FACS

Craig A. Reickert, MD, MBA, FACS, FASCRS

Judith A. Richmond, MD, FACS

Kaitlin Ritter, MD

Harry A. Roach, MD, FACS

Jacinta Robenstine, MD, FACS

Danny R. Robinette, MD, FACS

Ryan Rodriguez, MD

Todd K. Rosengart, MD, FACS

Simin Roward, MD

Valerie W. Rusch, MD, FACS

Nitin Sajankila, MD

Jarrett Santorelli, MD, FACS

Syed F. Saquib, MD, FACS

Mark D. Sawyer, MD, FACS

Thomas J. Schroeppel, MD, FACS

Douglas J.E. Schuerer, MD, FACS

Kevin M. Schuster, MD, FACS

Caleb N. Seavey, MD

Don J. Selzer, MD, FACS

Christopher K. Senkowski, MD, FACS

Neal E. Seymour, MD, FACS

Christian Shalgian

David S. Shapiro, MD, FACS

Jyotirmay Sharma, MD, FACS

Richard J. Shemin, MD, FACS

Perry Shen, MD, FACS

Brett C. Sheppard, MD, FACS

Richard A. Sidwell, MD, FACS

Dionne A. Skeete, MD, FACS

Jeffrey M. Smith, MD, FACS

Dustin L. Smoot, MD, FACS

Cheyenne Sonntag, MD

William C. Spanos, MD, FACS

Charles R. St. Hill, MD, FACS

Steven C. Stain, MD, FACS

Sneha Subramaniam, MD

Leah C. Tatebe, MD, FACS

Gail T. Tominaga, MD, FACS

Crystal F. Totten, MD, FACS

Brett Tracy, MD, FACS

Elizabeth N. Turner, MD, FACS

Kent R. Van Sickle, MD, FACS

Carlos A. Velazquez, MD, FACS

Gavin Ward

James A. Warneke, MD, FACS

Kaylee Watson

Jordan A. Weinberg, MD, FACS

Hunter B. Wessells, MD, FACS

Richard I. Whyte, MD, FACS

Scott M. Wilhelm, MD, FACS

Robert J. Winchell, MD, FACS

Russell K. Woo, MD, FACS

Grant Woodruff, DO

Deidre L. Wyrick, MD, FACS

Jerry Xiao, MD

Laurence F. Yee, MD, FACS

Kristen A. Zeller, MD, FACS

Michael J. Zinner, MD, FACS

Regulatory Update

New Rules Take Effect to Increase Data Access

As of October 6, surgeons and other stakeholders are now required to share electronic patient records and other information, under the 21st Century Cures Act. Physicians or other “actors” whose actions interfere with the access, exchange, or use of electronic health information (EHI) could be considered information blockers and subject to penalties or disincentives.

EHI, under this definition, includes any electronic protected health information in a designated record set. As defined by the HIPAA regulations, the designated record set typically includes patient medical and billing records, or other records used by physicians to make care decisions about patients.

Physicians, hospitals, electronic health record (EHR) vendors, health information exchanges (HIE) and health information networks (HIN) are all subject to Office of the National Coordinator for Health Information Technology’s regulations and considered “actors.” When these regulations first went into effect, actors were only required to share data elements that are included in the US Core Data for Interoperability standard to avoid information blocking penalties. However, now that the definition of EHI has been expanded, it is important for surgical practices to ensure they have implemented safe and effective processes that allow them to exchange or make EHI available upon request.

See What Surgeons Should Know About Information Blocking for more information, and contact qualitydc@facs.org with any questions.

Coding Webinar

Register for Free Webinar on New CPT Coding for Anterior Abdominal Hernia Repair

The ACS invites all members of the surgical team to attend a free webinar that will provide information about new CPT (Current Procedural Terminology) codes that take effect January 1 related to anterior abdominal hernia repair for umbilical, ventral, incisional, epigastric, spigelian, and parastomal hernias.

2023 CPT Coding for Anterior Abdominal Hernia Repair

Wednesday, November 9 | 8:00–9:00 pm ET

Attendees will benefit from insights shared by four surgeons with expertise in general surgery coding and reimbursement as they discuss the new coding structure, new global period, new add-on codes, and more. Presenters will also describe common clinical scenarios and correct coding to assist with understanding the 2023 anterior abdominal hernia repair coding paradigm.

Webinar presenters will include members of the ACS General Surgery Coding and Reimbursement Committee: Chair Christopher K. Senkowski, MD, FACS, Vice-Chair Don J. Selzer, MD, FACS, FASMBS, Charles D. Mabry, MD, FACS, and Ketan R. Sheth, MD, FACS.

For additional coding and billing education tools, visit the ACS Practice Management Resource Center. Contact Lauren Foe, Senior Associate for Regulatory Affairs, at lfoe@facs.org for more information.

State Affairs

Surgeons Successfully Advocate for Coverage of Breast Reconstruction Option in New York

On October 14, New York Governor Kathy Hochul signed AB 8537 into law, requiring insurance carriers to provide coverage and information on chest wall reconstruction surgery after a mastectomy or partial mastectomy.

Breast cancer is one of the most common cancers among women in New York, with more than 16,400 diagnosed with breast cancer each year, according to the New York State Department of Health.

More than 100,000 US women annually undergo some form of mastectomy. While most breast cancer patients who forgo traditional breast reconstruction expect aesthetic flat reconstruction to be included with mastectomy costs, the operation was not previously covered under most insurance policies.

The ACS New York State Chapter submitted letters of testimony throughout the legislative process supporting the bill and advocated for the bill’s passage during the annual New York State Advocacy Day in April 2022.

For more information on how your chapter can lead legislative efforts in your state, contact Rebecca King at rebeccaking@facs.org.

Chapters: Apply Today for 2023 State Advocacy Grant

The 2023 application for the ACS Chapter State Advocacy Grant is now available. Each year, ACS chapters are eligible to receive funding supporting for their state advocacy goals through the State Advocacy Grant Program.

While there is not a cap on funding requests, chapters must commit to a 50% match. For example, if a state chapter requests $5,000 from the ACS, it must be willing to provide an additional $2,500 toward an advocacy cause of its choosing, for a total of $7,500.

In the past, the grant was specific to sponsoring state advocacy days; however, state chapters may now use the funds in other impactful ways such as paying to join a coalition, launching a media campaign, or hiring a part-time lobbyist. There is no deadline for submitting applications, as they are accepted on a rolling basis.

Once submitted, the application will be reviewed internally by the ACS before being presented to a select committee of Fellows representing members from the Health Policy and Advocacy Group, Legislative Committee, and Health Policy Advisory Council.

For more information on the Chapter State Advocacy Grant, contact Rebecca King at rebeccaking@facs.org.