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

Bulletin Advocacy Brief: June 3

President Releases FY22 Budget

President Biden released his first full budget request to Congress on May 28. The fiscal year (FY) 2022 budget would increase federal spending to $6 trillion in the coming year, with annual deficits of approximately $1.3 trillion over the next decade.

For the U.S. Department of Health and Human Services (HHS), the budget includes a total of $133.7 billion—a 23.4 percent increase over FY 2021. Funding increases were included for the Office of Civil Rights, which would receive $430 million; the Office of the Inspector General, which would receive $430 million; and the Centers for Medicare and Medicaid Services (CMS), whose discretionary funding would total $4.3 billion. The Food and Drug Administration (FDA) would receive $6.5 billion, a $477 million increase, including $3.6 billion in discretionary funding and $2.9 billion in user fees. The National Institutes of Health (NIH) would receive a total of $52 billion, a $9 billion increase. This budget increase includes $6.5 billion for the creation of the President's proposed Advanced Research Projects Agency for Health. The Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry would see a total spending level of $8.7 billion, a $1.6 billion increase. The Biomedical Advanced Research and Development Authority's budget would increase by $227 million for a total of $823 million.

The President's budget is a high-level wish list that will serve as a blueprint for Congressional Democrats working to write FY22 spending bills. For more information, contact Amelia Suermann, ACS Congressional Lobbyist, at asuermann@facs.org.

U.S. Senate Confirms CMS Administrator

Chiquita Brooks-LaSure was confirmed by the U.S. Senate to serve as Administrator of CMS by a 55–44 vote May 25. Ms. Brooks-LaSure is a former Obama administration health official who helped implement the Affordable Care Act (ACA) while serving as deputy director for policy at the Center for Consumer Information and Insurance Oversight. Earlier in her career, she was a staffer for the House Ways and Means Committee, where she helped to draft the ACA while working with HHS Secretary Xavier Becerra, who served on the panel during his time in Congress. Most recently, she chaired President Biden's health transition team.

For more information, contact Amelia Suermann, ACS Congressional Lobbyist, at asuermann@facs.org.

Lymphedema Treatment Act Reintroduced in U.S. Congress

The Lymphedema Treatment Act (H.R. 3630/S. 1351) was recently re-introduced by Reps. Jan Schakowsky (D-IL), Buddy Carter (R-GA), Earl Blumenauer (D-OR) and Mike Kelly (R-PA) in the U.S. House of Representatives and in the U.S. Senate by Senators Maria Cantwell (D-WA) and Chuck Grassley (R-IA).

Complete decongestive therapy (CDT) is the standard of care for lymphedema and is a multimodal treatment that is only effective when used in its entirety. The current lack of Medicare coverage for the compression supplies used in daily treatment, an essential component of CDT, presents a roadblock for patients to access the full spectrum of care. As a result, many patients suffer from recurrent infections, progressive degradation in their condition and eventual disability because they cannot access the compression supplies required to treat the condition. This legislation aims to improve insurance coverage for the medically necessary, doctor-prescribed compression supplies that are the cornerstone of lymphedema treatment. Although this bill will only change Medicare law, ACS believes it will set a standard for Medicaid and private insurance to follow.

Read the ACS letter of support to the Senate. For more information, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at czlatos@facs.org.

ONC Seeks Feedback on Future Health Interoperability Outcomes

The Office of the National Coordinator for Health Information Technology (ONC) recently released a request for feedback to inform the development of a new initiative, "Health Interoperability Outcomes 2030." In a recent press release, ONC stated that they intend to publish "a prioritized set of interoperability outcomes that align with ONC's interoperability vision for the nation and the 2020– 2025 Federal Health IT Strategic Plan." ONC plans to use stakeholder feedback to shape the goals that the agency hopes to achieve over the next decade. The ACS has begun reviewing the request for feedback and plans to submit comments to ONC.

More information about this request for feedback can be found on ONC's Health IT Buzz.

Information Blocking Regulations Now in Effect

The ONC published a Final Rule in May 2020 that officially defines Information Blocking as: "A practice that is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information (EHI)." The rule also outlines the parties who might be considered information blocking "actors," and provides examples of reasonable exceptions and enforcement mechanisms for actors who engage in information blocking. It is important to note that while these rules have gone into effect and established civil monetary penalties up to $1 million per violation for developers of Certified Health IT vendors, health information networks, and health information exchanges who engage in information blocking, the Office of the Inspector General (OIG) has not yet finalized any civil monetary penalties for health care providers (physicians, hospitals, ambulatory surgery centers, and so on). The original implementation dates for these regulations were delayed due to the COVID-19 pandemic but went into full effect on April 5, 2021. Physicians are now required to respond to any legitimate request to exchange or provide access to EHI stored in their electronic health record systems.

To offer more details about the information blocking rules, exceptions and ways to comply, the ACS posted a new web page "What Surgeons Should Know About: Information Blocking." The ONC website also offers fact sheets and other resources on the new information blocking provisions.

Any additional questions related to the Information Blocking Regulations or other policies set forth in the ONC Final Rule can be directed to QualityDC@facs.org.