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

Bulletin Advocacy Brief: October 22

Your Advocacy in Action—More than Half the U.S. House of Representatives Urge Leaders to Act to Protect Patient Access to Surgical Care

Representatives Ami Bera, MD (D-CA); Larry Bucshon, MD, FACS (R-IN); Brendan Boyle (D-PA); George Holding (R-NC); Raul Ruiz, MD (D-CA); Roger Marshall, MD (R-KS); Abby Finkenauer (D-IA); Brad Wenstrup, DPM (R-OH); and 221 colleagues, sent a letter on October 19, 2020, to Speaker of the House Nancy Pelosi and House Minority Leader Kevin McCarthy urging them to protect patients by stopping planned Medicare cuts that will impact physicians across the country.

The bipartisan letter outlines the negative impact these cuts will have on the health care system and patient access to care and calls for Congress to act and stop them from taking effect on January 1, 2021. 

"Payment cuts of this magnitude will surely strain a health care system that is already stressed by the COVID-19 pandemic and could jeopardize patient access to medically necessary services," write Reps. Bera and Bucshon. "In order to safeguard beneficiaries' access to care during this pandemic, we as Congress should examine possible bipartisan solutions to address excessively steep cuts. We encourage you to incorporate the resulting policy changes in any upcoming legislation moving through the House."

The congressional attention to stopping the Medicare payment cuts is in large part due to the concerted efforts of the American College of Surgeons and its membership, alongside the Surgical Care Coalition. The ACS Division of Advocacy and Health Policy has worked with ACS Fellows and members to facilitate contact with their representatives through SurgeonsVoice—and surgeons have sent thousands of letters to Congress telling them to say "No!" to Medicare payment cuts.

"Now is not the time to cut Medicare payments for any health care providers, which could jeopardize the care of older Americans," said ACS Executive Director David B. Hoyt, MD, FACS. "We are grateful to Reps. Bera and Bucshon, who are also physicians, for their leadership and support in ensuring patients continue to have access to surgical care they need."

The ACS continues its efforts to advocate on behalf of surgeons and stop the Medicare cuts. This letter is an example of that advocacy, but your help is still needed! You can write to Congress and urge them to act now to stop the cuts in just a few clicks—act now!

Take Action: Tell Your Member of Congress to Support Surgeons!    

This week's developments prove that the hard work surgeons have done to stop these cuts is having an impact. We now have a letter with huge bipartisan support in Congress—but the fight isn't over. We need you to keep pushing to have our voices heard. Surgeons know better than anyone how these cuts will hurt patients and continue to devastate an already delicate health care system. Please take the time to write another letter to your member and share this email with your colleagues, your patients and your friends. Please take a moment to help us reach our goal of sending 10,000 letters to Congress by contacting your lawmaker and sharing this email with your colleagues, your patients and your friends. 

Make your voice heard by heading to SurgeonsVoice and tell your representatives to stop the cuts!

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October Advocacy at Home Push Continues: Update Your Contact Information to Make It Easier to Reach your Legislators

Take a moment to review your SurgeonsVoice profile and update your contact information to ensure that the ACS has your personal/home address, email and mobile number. This is critical to connect you with your legislators and track grassroots engagement to and make sure you are receiving information about important ACS advocacy priorities.

Contact ACS DAHP staff at ahp@facs.org with any questions.

Congressional Champions Seek Solutions to Prevent Medicare Payment Cuts Slated for January 2021

In August, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year 2021 Medicare Physician Fee Schedule (PFS) proposed rule—doubling down on a policy that will have drastic consequences for Medicare patients seeking surgical services at a time when physician practices are struggling to stay afloat. The CY 2021 rule increased rates for the office-based evaluation and management code set, but due to the requirement for budget neutrality under the PFS, this will result in a significant cut for a large portion of specialty care beginning on January 1, 2021.

Over the last few months, there has been a significant uptick in Congressional activity related to the pending payment cuts. The ACS continues to urge Congress to take immediate action to prevent these cuts before the end of the year.

In the U.S. House of Representatives, there has been increased attention to this issue as members of Congress have heard from the ACS and other health care professional stakeholders stressing the urgency of preventing the payment cuts. Significant grassroots efforts from ACS Fellows have led to a strong showing of support from Congressional leaders on this issue, as follows:

  • On August 11, Rep. Bobby L. Rush (D-IL), joined by a bipartisan coalition of 92 members of Congress, sent a letter to Speaker Nancy Pelosi (D-CA) and Majority Leader Kevin McCarthy (R-CA) urging House Leadership to protect patients and medical professionals by including in any moving legislative package a provision to waive the requirements for budget neutrality under the Medicare PFS for 2021 and 2022. Waiving the requirements for budget neutrality would temporarily prevent the cuts to specialty care while allowing the increased E/M code values to be implemented.
  • On September 24, Reps. Roger Marshall, MD (R-KS), Rush, Brad Wenstrup, DPM (R-OH), Terri Sewell (D-AL), David McKinley (R-WV) and Tom O'Halleran (D-AZ) led a bipartisan letter signed by more than 160 members of Congress in asking Department of Health and Human Services Secretary Alex Azar and CMS Administrator Seema Verma to use their regulatory authority to engage with stakeholders to expeditiously establish a fair and equitable payment solution that addresses Medicare payment cuts before they go into effect.
  • On October 2, Reps. Michael Burgess, MD (R-TX) and Rush introduced legislation, H.R. 8505, to provide a one-year waiver of budget neutrality adjustments under the Medicare physician fee schedule. This legislation would pay for the one-year reprieve through the COVID-19 Provider Relief Fund. The ACS signed a coalition letter thanking the bill sponsors for their leadership in working to prevent the payment cuts.
  • On October 19, Reps. Ami Bera, MD (D-CA); Larry Bucshon, MD, FACS; Brendan Boyle (D-PA); George Holding (R-NC); Raul Ruiz, MD (D-CA);  Marshall; Abby Finkenauer (D-IA); Brad Wenstrup, DPM (R-OH), led a bipartisan coalition of 229 members of Congress in sending a letter to Congressional leadership stressing the urgency for Congress to pass legislation to prevent these cuts before the end of the year (see top story for more details).

On the Senate side, Senator Susan Collins (R-ME) sent a letter to Senate Majority Leader Mitch McConnell and Minority Leader Charles Schumer as well as Senate Finance Committee Chairman Charles Grassley (R-IA) and Ranking Member Ron Wyden (D-OR) urging legislative action before the end of the year to either waive the budget neutrality requirements under the Medicare PFS or hold health care providers harmless from the cuts associated with the finalized E/M code policies slated for implementation on January 1, 2021.

The ACS continues to work with Congressional leaders in identifying and implementing a solution before the end of the year. Visit SurgeonsVoice to contact Congress today and urge lawmakers to prevent cuts to Medicare payment for surgical services.

For more information on legislative efforts related to physician payment, contact ACS Senior Congressional Lobbyist Carrie Zlatos at czlatos@facs.org 

ACS Joins Coalition in Urging Congress Not to Enact Surprise Medical Billing Proposal that Could Harm Physicians

Earlier this month, the ACS joined a coalition of medical professional organizations in sending a statement to Congressional leadership outlining concerns with a potential surprise medical billing proposal. Negotiations are ongoing between interested parties in the House and Senate, although key leaders have not yet released an official proposal.

The coalition statement urges Congress to work towards more balanced policy that does not favor the insurance industry and highlights concerns with continued usage of tying the median in-network rate to payment for out-of-network claims. Additionally, the rumored proposal includes an implementation date of the independent dispute resolution process that starts more than a year after the effective date banning surprise medical bills. During the interim implementation year, payments to out-of-network physicians would be based on median in-network rates with no ability to adjudicate disputes. Adding to the pressure on negotiations, the President issued an Executive Order in September calling for Congress to pass a solution before the end of the year. If Congress does not act, the EO stated that the Department of Health and Human Services will take administrative action to prevent surprise medical bills.

For more information on legislative action as it pertains to surprise medical billing, contact ACS Senior Congressional Lobbyist Carrie Zlatos at czlatos@facs.org.

ACS Encourages Further Committee Action on Ensuring Lasting Smiles Act

Last week, the ACS, along with 28 other organizations, signed a letter to the House Education and Labor Committee asking the committee to quickly approve H.R. 1379, the Ensuring Lasting Smiles (ELSA) Act. Most recently, the Energy and Commerce Committee approved and passed this bill on September 9. Because both committees share jurisdiction over the bill, the Education Committee needs to hold a markup to review the legislation or suspend their right to review in order for the bill to be considered before the full House of Representatives.

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 letter. For further information, contact Hannah Chargin, ACS Congressional Lobbyist at hchargin@facs.org.