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

Bulletin Advocacy Brief: August 27

CMS Payment Cuts: How Will They Affect General and Specialty Surgeons?

By now, many of you know that most surgical specialties will face significant cuts as part of the pending Centers for Medicare & Medicaid Services’ (CMS) proposed rule set to go into effect just months from now. But not every specialty will face the same challenges. Cardiac surgery will be among the hardest hit, as Medicare payments will be slashed by 9 percent, whereas thoracic surgery will face an 8 percent reduction—shocking amounts for these high-cost and high-risk procedures. Unfortunately, these massive cuts aren’t unique and will hinder surgeons’ ability to provide the same quality of care that they provide today. Do you know how much CMS is cutting your specialty? Find out by reading the Surgical Care Coalition fact sheet.

Take Action: Tell Congress to Stop the Cuts!

Surgeons have been loud and clear—CMS’ proposed cuts will ignore patients and continue to devastate an already stressed health care system. These cuts were bad for patients and surgeons since CMS announced the proposal in November 2019, before the COVID-19 pandemic, but if implemented in January, will create a number of new hardships for surgical patients. Make your voice heard by heading to SurgeonsVoice and telling your representatives to stop the cuts!

These cuts will limit access to care for our most vulnerable population. We encourage you to share this newsletter with your patients so they can learn about this critical issue and support physicians by writing to your representatives.

Contact your senators and representatives

Schedule an In-District Meeting with Your Elected Officials Using SurgeonsVoice

Meeting with members of Congress when they return home to the district is an important part of advocacy. Particularly during the COVID-19 pandemic, lawmakers are looking to health care professionals to educate them about critical issues facing the medical community and patient access to care. Scheduling a meeting or virtual visit with your legislators to discuss surgical advocacy priorities has never been easier. Visit SurgeonsVoice to learn more about the ACS’ current legislative efforts and schedule a meeting with your legislators today.

“This was the easiest tool I’ve used,” according to American College of Surgeons (ACS) Governor David J. Welsh, MD, FACS, a general surgeon in Indiana (pictured right). “I requested a meeting with my congressman and received a call from the office within a couple of days, without any additional follow-up. Not only did the office contact me in response to my outreach, but Rep. [Greg] Pence [R-IN] (pictured left) offered to come to my office for a socially distant visit that resulted in an hour-long discussion about important ACS advocacy priorities.”

Rep. Greg Pence and ACS Fellow David J. Welsh

For questions, or to request specific talking points once your meeting is set, contact ACS Division of Advocacy and Health Policy (DAHP) staff at ahp@facs.org.  


Dr. Paula Ferrada and Dr. Misty Humphries: These Cuts Would Have “Terrible Consequences”

Adding their voices to the opposition to the CMS’ latest proposed physician payment rule, Paula Ferrada, MD, FACS, and Misty D. Humphries, MD, MAS, RPVI, FACS, authored opinion pieces in their local papers to explain how these Medicare cuts will harm their patients.

In the Richmond Times-Dispatch, Dr. Ferrada, a trauma surgeon and professor of surgery at Virginia Commonwealth University, Richmond, predicts the American health care system will move closer  to that of countries such as her native nation of Colombia and others in the developing world. If this happens, she writes, it will result in “terrible consequences of insufficient or delayed access to quality care.”

Meanwhile, in the FresnoBee and Merced Sun-Star, Dr. Humphries, a vascular surgeon and associate professor of surgery at the University of California Davis, outlines the “vascular deserts” in California, demonstrating how cuts to Medicare payments will dramatically reduce elderly and rural patient access to vascular care throughout the region. As she explains, “Our region is already facing enough challenges right now. We don’t need to make it worse.”  Read Dr. Ferrada's op-ed in the Richmond Times-Dispatch and Dr. Humphries' full opinion piece in The Fresno Bee or Merced Sun-Star.

2019 MIPS Performance Feedback and Final Scores Now Available

CMS has released the Merit-based Incentive Payment System performance feedback and final scores for the 2019 performance year. These reports will affect 2021 payment. If you submitted data for the 2019 performance period, you can view your MIPS performance feedback, which includes your final scores and payment adjustment information by logging in to the Quality Payment Program portal with the same credentials that you used to submit your 2019 MIPS data.

Your final score will dictate the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment applied to the 2021 Medicare payment amount for covered professional services. If you believe an error has been made in calculating your MIPS payment adjustment, you have until October 5, 2020, to request a targeted review. You can submit the request by using your credentials to log in to your QPP Portal. 

To learn more about performance feedback, review the 2019 MIPS Performance Feedback Resources, including the following: 

  • 2019 MIPS Performance Feedback FAQs
  • 2019 MIPS Performance Feedback Patient-Level Data Reports FAQs.

For additional information about how to request a targeted review, refer to the 2019 Targeted Review User Guide.

All additional questions should be directed to QualityDC@facs.org.

COVID-19 Relief Bill Efforts Reach a Stalemate

The U.S. House, Senate, and White House remain at an impasse on what should be included in a fourth COVID-19 relief bill. The House passed the HEROES Act, H.R. 6800, in May, and negotiations have reached a stalemate, with both chambers ultimately departing for the August in-district work period.

The House briefly returned to Washington this weekend to vote on legislation that would strengthen the U.S. Postal Service but adjourned without considering any COVID-19 relief legislation. Meanwhile, Senate Republicans are considering the introduction of a “skinny” COVID-19 package that would include additional funding for USPS, the Paycheck Protection Program, unemployment benefits, and COVID-19 testing, given the continued impasse between the White House and congressional Democrats on the next piece of stimulus legislation.

Timing remains unclear, but passage of any relief bill is unlikely to occur before mid-September. At that time, Congress also will need to swiftly act to prevent a government shutdown when the fiscal year ends September 30.

Reminder: ACS Telehealth Webinar Is Today!

Register today for an important webinar on telehealth hosted by the ACS DAHP. The webinar will take place 8:00−9:00 pm (EDT) today.

A key focus of the program will be the series of waivers the U.S. Department of Health and Human Services issued temporarily lifting certain constraints on coverage for telehealth and other virtual services during the COVID-19 public health emergency. Two surgeons—Stephen M. Sentovich, MD, MBA, FACS, clinical professor of surgery and physician lead, clinical operations, City of Hope, Duarte, CA; and Catherine A. Matthews, MD, FACS, FACOG, professor of urology and gynecology, Wake Forest Baptist Health, Winston-Salem, NC—will describe how they successfully integrated virtual care platforms into their workflows during the PHE. Attendees will benefit from insights shared by Drs. Sentovich and Matthews about early lessons from operationalizing telehealth since the onset of the COVID-19 pandemic and key considerations for implementing virtual services in surgical practice now and in the future.

Details are as follows:

Telehealth and Surgery during the Pandemic: Lessons Learned and Guidance for the Future

Thursday, August 27 | 8:00–9:00 pm (EDT)

Register

Contact Lauren Foe, Senior Associate for Regulatory Affairs, at lfoe@facs.org with questions.

Share Your Feedback on Telehealth in Surgical Practice

The ACS seeks feedback on the impact of telehealth expansion on surgical practice during the COVID-19 public health emergency. The ACS DAHP encourages Fellows to complete a brief questionnaire regarding telehealth use throughout the pandemic, the results of which will inform the College’s policy positions for virtual services in the post-COVID-19 world. 

Access the questionnaire

ICYMI: Dr. David Hoyt for CNN: “Doctors Need Congress to Help Them”

David B. Hoyt, MD, FACS, ACS Executive Director, authored an op-ed on CNN.com warning about the devastating consequences the proposed CMS cuts could have. Dr. Hoyt explains that  the U.S. surgical care system already faces “significant structural challenges,” including high fixed costs and debt, combined with plummeting revenue. The cost of being a surgeon continues to rise while Medicare's surgical payments don’t even keep pace with inflation. With these cuts, surgeons will be forced to make difficult decisions about how to run a practice while providing the same level of quality care their patients deserve. As Dr. Hoyt states, “Our medical system needs all the help that it can get right now,” which is why the ACS is urging Congress to enact legislation and waive Medicare's budget neutrality requirements. Read the full op-ed on CNN.com.