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

Bulletin Advocacy Brief: September 10

Get Out the Vote: Become an Active Participant in ACS Advocacy and Political Programs

Legislative and regulatory policies can directly affect surgeons and patients. Fellows of the American College of Surgeons who participate and leverage their voices through advocacy and political activity help to establish the surgical profession’s position and allow the ACS to serve as a trusted resource to lawmakers while working to impact important health policy priorities.

The 2020 election cycle is proving to be one of the most unpredictable, significant elections in recent years, which is why it is important to become more involved and get out the vote. Many candidate platforms include proposals pertaining to Medicaid and Medicare, health information technology, research, funding and other health care issues that have the potential to affect surgical practice and surgical patient care. Particularly during this public health pandemic, in Washington, DC, and at home, it is critical that all surgeon advocates engage with their elected officials, educate lawmakers about issues affecting surgery and surgical patients and regularly communicate with the American College of Surgeons Division of Advocacy and Health Policy regarding these efforts.

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Dr. Nicolas Mouawad: Vascular Patients “Can’t Afford to Wait.”

Cardiovascular disease disproportionately affects older patients, with many of them relying on Medicare to get the surgical care required to maintain a high quality of life. Unfortunately, the Centers for Medicare & Medicaid Services (CMS) plans to slash Medicare payments for vascular surgeons by 8%, which will make it difficult for older Americans to access the care they need to stay healthy and active. In a sponsored article in STAT News, Nicolas Mouawad, MD, MPH, MBA, FSVS, FRCS, FACS, RPVI, explains how CMS’s proposed payments cuts  “will lead to reduced access to care and increased wait times for patients to get care,” and in the world of vascular surgery, “time is tissue.”

Dr. Mouawad asks Congress to intervene and stop the cuts because if they go into effect on January 1, 2021, surgeons may be forced to shut their practices and hospitals won’t be able to operate. Read more from Dr. Mouawad in STAT News.

Your Input Needed: 2021 Physician Fee Schedule Survey

On behalf of the ACS and the Surgical Care Coalition, we are asking for your participation in a survey to help with our advocacy efforts against the recently announced Physician Fee Schedule for 2021. We estimate that the survey should take less than 10 minutes to complete. We would be grateful for your participation in this effort. If you wish to take the survey, please click HERE or the button below to get started. We ask for you to complete the survey by September 14 at 6:00 pm EDT.

Tell Your Patients: These Cuts Will Hurt Access to Surgical Care

Congress is noticing the work of surgeons speaking out on the threat of the Medicare payment cuts. But we need more voices. Tell your patients how they can learn about this critical issue and take action to support physicians before it’s too late. If these cuts take effect in January 2021, access to surgical care is at stake by limiting access to surgical care for one of our most vulnerable populations.

ACS-Supported Legislation Advances Out of Committee

The House Energy and Commerce Committee held a virtual markup September 9 reviewing 38 bills addressing mental health, opioids and improving access to Medicare. Two ACS-supported bills were included in this review: H.R. 1379, the Ensuring Lasting Smiles (ELSA) Act, and H.R. 5855, the Bipartisan Solutions to Cyclical Violence Act of 2020.

ELSA would address issues that prevent access to necessary diagnosis and treatment for patients with congenial craniofacial anomalies such as such as cleft lip and palate, skeletal and maxillofacial abnormalities, facial paralysis, microtia, hypodontia and craniosynostosis. ELSA would require all private group and individual health plans to cover medically necessary services that repair or restore a patient’s anomaly. Read the coalition letter of support.

The Bipartisan Solution to Cyclical Violence Act, would provide grant funding to create new hospital-based violence intervention programs, as well as expand successful programs already in place. In addition, the bill calls for research on best practices, which will play a critical role in documenting the success of these programs and will create a road map for hospitals to follow. Read the ACS COT letter of support.

Now that these bills have been reviewed by the appropriate committee, House leadership should schedule them for consideration before the full House. For further information on these bills, contact Hannah Chargin, ACS congressional lobbyist, at

Dr. David Smail: “CMS Rule Forces Surgeons to Run Faster Just to Stay in The Same Place.”

Small-town surgeons will bear the brunt of the Medicare payment cuts, and these physicians play an important role in their communities and local economies.

David Smail, MD, FACS, has practiced surgery in Beverly, MA for 15 years, and hopes to continue practicing there until he retires. Dr. Smail warns, in a sponsored article in Modern Healthcare, that the pending cuts to Medicare payments could cause “thousands of surgeons across the country shutter their practices,” as the costs of operating go up, but payments take a significant drop. His practice performs more than 2,000 surgeries a year, and if his practice closes, residents of Beverly will lose access to high quality, and most importantly, local care.

Private practices are small businesses and they cannot operate on the huge deficits that the CMS rule will create. Dr. Smail explains that the “only way to protect our surgeons and their communities” is for Congress to intervene and stop the cuts. Read the full article in Modern Healthcare.

ACS Supports Tax Burden Relief Legislation

The ACS recently supported legislation led by Reps. Cindy Axne (D-IA) and Neal Dunn, MD (R-FL) and Senator Marsha Blackburn (R-TN) to reduce tax burdens on surgeons who received financial assistance. In response to COVID-19, Congress authorized $175 billion for the Public Health and Social Services Emergency Fund to help health care providers cover expenses and lost revenue due to the pandemic. While the Department of Health and Human Services has utilized the Provider Relief Fund to distribute this critical assistance, surgeons and other health care providers that pay federal taxes face significant tax penalties that undermine the utility of the aid.

According to the American Medical Association, the Federation of American Hospitals, and a wide-range of health care organizations, these tax requirements may cause taxpaying health care providers to lose 21 percent or more of the benefit as compared to non-taxpaying providers.

The Eliminating the Provider Relief Fund Tax Penalties Act of 2020 (H.R. 7819 and S. 4525) would ensure that all health care providers, regardless of taxpaying status, not be subject to taxes on aid provided through the PRF and guarantees that expenses attributable to the PRF are tax deductible. By guaranteeing that PRF relief funds do not add to providers’ tax bills, surgeons and other health care providers can utilize the full value of their benefit. For further information on this legislation, please contact ACS Manager of Legislative and Political Affairs, Kristin McDonald, at

Senate HELP Committee Conducts Hearing on Vaccines and Public Health

The Senate Committee on Health, Education, Labor, and Pensions is holding a hearing on September 9, “Vaccines: Saving Lives, Ensuring Confidence, and Protecting Public Health.” The Committee plans to hear testimony from Francis Collins, MD, PhD, Director of the National Institutes of Health, and VADM Jerome M. Adams, MD, MPH, Surgeon General of the U.S. Department of Health and Human Services. A significant portion of the hearing is likely to focus on ensuring the safety of a potential COVID-19 vaccine considering the political concerns regarding rushed vaccine approval in advance of the presidential election.

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

Congress Has a Packed Agenda This Fall

The U.S. Congress returned from its in-district work period with few legislative days to tackle a growing list of priorities, chief among them COVID-19 legislation and keeping the government funded to avoid a shutdown. With negotiations between both parties and the White House over the next round of COVID-19 relief at a standstill and little chance of a breakthrough, Senate Republicans introduced a “skinny” COVID-19 bill that would provide targeted relief. The legislation includes liability for hospitals and health care workers, including liability limitations for COVID-related malpractice claims and creates federal causes of action for medical malpractice laws and preempts conflicting state laws. Additionally, the bill includes funding for a second round of Paycheck Protection Program loans, support and assistance for the postal service, education and childcare and continued pandemic response. It remains unclear if the bill can pass through the Senate and how much support there is for this approach as Senate Democrats continue to advocate for broader COVID relief.

In addition to COVID-19 relief legislation, Congress will need to act to prevent a government shutdown when the fiscal year ends September 30. Speaker of the House Nancy Pelosi (D-CA) and Treasury Secretary Steve Mnuchin announced an informal deal on a Continuing Resolution (CR), the exact details of which have not been made public. It is expected that the CR would fund the government until sometime in December, setting up the likelihood of another CR or broader spending package after election day during the “lame duck” session of Congress at the end of the year. Further complicating the scenario is that the funding for various health programs, such as funds for Community Health Centers, Graduate Medical Education, the National Health Service Corps, Medicaid Disproportionate Share Hospitals and other critical programs, will need to be extended before they expire on November 30. How those extenders are handled remains to be seen.

For more information, contact Amelia Suermann, ACS Congressional Lobbyist, at

2020 Advocate of the Year Program Recognizes Surgeons Performing “A Cut Above” the Rest

Surgeon advocates who regularly participate in ACS advocacy activities are essential to expanding the College’s grassroots network. The Advocate of the Year program from the Division of Advocacy and Health Policy considers how engaged advocates utilize advocacy resources, contact Congress about important advocacy priorities and work to educate and involve their peers. The Advocate of the Year will be recognized at the annual Clinical Congress, featured in the ACS Bulletin Brief and invited to participate in other advocacy-related activities.

As of August 15, the following surgeon advocates are candidates for the 2020 Advocate of the Year award: John H. Armstrong, MD, FACS; Jay J. Doucet, MD, FACS, FRCSC; Shannon M. Foster, MD, FACS; Soha Ghossaini, MD, FACS; Marion C.W. Henry, MD, MPH, FACS, FAAP; Atul N. Jani, MD, FACS; Krista L. Kaups, MD, MPH, FACS, FAAP; Deborah A. Kuhls, MD, FACS; Joe H. Patton MD, FACS; and Kristan Staudenmayer, MD, MS, FACS.

For more information, visit the Advocate of the Year web page.

Protecting Patients: New Surgical Care Coalition Video

Medicare payments and surgical codes are complicated. The Surgical Care Coalition has produced a new video that explains the Medicare payments cuts.

Watch this video and share it with your colleagues to inform them about how the proposed cuts will impact their patients. The more surgeons that know about these cuts, the more surgeons will take action and help us stop the cuts. Watch the latest Surgical Care Coalition video.