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

Bulletin Advocacy Brief: March 25

Xavier Becerra Sworn in as Secretary of Health and Human Services

Last week, the Senate voted 50-49 to confirm Xavier Becerra to serve as Secretary of the Department of Health and Human Services (HHS). Senator Susan Collins (R-ME) was the lone Republican senator to join the Democrats in voting to confirm. Senator Mazie Hirono (D-HI) did not vote. Secretary Becerra most recently served as the Attorney General for the state of California and was previously a member of the U.S. House of Representatives. During his tenure in Congress, he held a position on the House Committee on Ways and Means, which has jurisdiction over the Medicare program. On March 19, Secretary Becerra was sworn in as HHS Secretary and his initial focus will be getting the COVID-19 pandemic under control.

For more information, contact ACS Senior Congressional Lobbyist, Carrie Zlatos, at

Legislation Expanding GME Introduced in U.S. Senate

U.S. Senators Robert Menendez (D-NY), John Boozman (R-AR), and Senate Majority Leader Charles Schumer (D-NY) on March 18 introduced the Resident Physician Shortage Reduction Act of 2021 (S. 834), legislation that would create 14,000 new Medicare graduate medical education slots. The bill is similar to versions introduced in previous sessions of Congress but has been updated to reflect the 1,000 new GME slots and distribution methodology created by the year-end Consolidated Appropriations Act. The legislation distributes the slots over a period of seven years, with 2,000 slots per year, beginning in 2023 through 2029.

In determining which hospitals would receive slots, the Centers for Medicare & Medicaid Services would be required to consider the likelihood of a teaching hospital filling positions and would be required to distribute at least 10 percent of the slots to each of the following categories of hospitals: rural training hospitals, hospitals training over their current GME caps, hospitals in states with new medical schools or branch campuses, and hospitals in areas designated health professional shortage areas. Additionally, the legislation requires the Government Accountability Office to conduct a study on strategies for increasing health professional workforce diversity, including an analysis of strategies for increasing the number of health professionals from rural, lower income and underrepresented minority communities. The ACS expects the companion bill to be introduced in the U.S. House of Representatives as early as this week.

The ACS joined a broad group of stakeholders in signing a letter of support for the legislation. Read the letter to the House of Representatives and the letter to the Senate. For more information about GME or workforce issues, contact Amelia Suermann, ACS Congressional Lobbyist, at

Congress Working to Prevent Medicare Cuts

On March 15, 2021, U.S. Senators Jeanne Shaheen (D-NH) and Susan Collins (R-ME) introduced the Medicare Sequester Relief Act (S. 748), bipartisan legislation that would prevent substantial payment cuts to Medicare payments to health care providers from taking effect during the COVID-19 public health emergency. The U.S. House of Representatives passed its version of the legislation (H.R. 315) on March 15, 2021.

Before passage of H.R. 315, the ACS joined stakeholders in signing a letter to congressional leadership urging action to prevent sequestration related Medicare cuts. Specifically, the letter requested that Congress extend the current moratorium before it expires on April 1 and to prevent the projected 4 percent Medicare spending cuts (approximately $36 billion) that are scheduled to occur next year. The 4 percent cut was a result of using the budget reconciliation process to enact the American Rescue Plan Act of 2021, which triggered "Pay-As-You-Go" (PAYGO) rules. PAYGO rules require that that new legislation not increase the federal budget deficit or reduce the surplus. If legislation subject to PAYGO increases the deficit through an increase in federal spending or a reduction in revenues, that increase must be offset by increased revenue or reduced spending in other areas. The PAYGO cuts to Medicare are capped at 4 percent

Take Action

Contact your senators and urge them to cosponsor S. 748 – bipartisan legislation to extend the delay of sequestration-related payment cuts through the end of the declared COVID-19 PHE.

Contact your senators now!

The ACS is continuing to work as part of a broad coalition to ensure inclusion of S. 748 in must-pass legislation. For more information about sequestration, contact Amelia Suermann, ACS Congressional Lobbyist, at

ACS Joins Letter to Veterans Health Administration on COVID-19 Impact on Surgical Resident Training

Surgical residency training programs have been challenged due to nationwide shutdowns of elective surgical procedures during the COVID-19 public health emergency with widespread variability in resumption of these services across the country. Consequently, surgical residents have had difficulty meeting the Accreditation Council for Graduate Medicare Education and American Board of Medical Specialties standards for completing their training. Resident training programs have long-standing partnerships with Veteran's Affairs medical centers to facilitate training of new physicians, as well as to enhance the quality care provided to veteran patients.

A letter encouraging a partnership between surgery and the VA's Office of Academic Affiliation to develop solutions to enhance and/or sustain surgical training during the PHE was sent to the Veterans Health Administration. These solutions could also help maintain veterans' access to the highest quality care.

Read the letter. For further information on this issue, contact ACS Manager of Legislative and Political Affairs Kristin McDonald, at