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

July 2014 ACS Advocate


Welcome to the July edition of The ACS Advocate. This month we’ll be brief!

As Congress prepares to adjourn for the July 4 recess, the American College of Surgeons (ACS) advocacy and health policy staff are gearing up for what’s expected to be an unpredictable election season. Meanwhile, we have a few updates and reminders on federal level issues, and things are heating up at the state level. Take a look inside this issue…

At the Federal Level

Trauma Care Legislation Passed in House

Sunshine Act User Registration

EHR Hardship Exemption Deadline July 1

Attend August Coding Workshop

At the State Level

New Louisiana Optometry Legislation

Youth Concussion Prevention

Michigan Trauma Funding

Advocacy Efforts Stymie New York Legislation

Massachusetts Trauma Registry

Uncompensated Care in Medicaid Expansion

PAC and Grassroots

Plan an In-District Meeting

Other News of Interest

At the Federal Level

House passes trauma and emergency care legislation

On June 24, the U.S. House of Representatives passed H.R. 4080, the Trauma Systems and Regionalization of Emergency Care Pilot Projects Reauthorization Act. H.R. 4080 would reauthorize the following: (1) the Trauma Care Systems Planning Grants, which support state and rural development of trauma systems; and (2) the Regionalization of Emergency Care Systems Pilot Projects, which are aimed at laying the groundwork for the implementation and evaluation of innovative models of regionalized emergency care. The legislation also directs states to update their model trauma care plan with input from new stakeholders one year after enactment.

On May 22, Sens. Jack Reed (D-RI), Mark Kirk (R-IL), Patty Murray (D-WA), and Johnny Isakson (R-GA) introduced Senate companion legislation S. 2405.

Physician Payments Sunshine Act user registration is open

Physicians and teaching hospitals can register now in the Centers for Medicare & Medicaid Services (CMS) Enterprise Portal to request access to the Physician Payments Sunshine Act (PPSA) open payments system, which will become available in July. Although the PPSA does not require physicians to take action, nor does it impose any penalties on physicians, registration is required for physicians and teaching hospitals to review and dispute their open payments information. Learn more about the PPSA in the Bulletin.

Act now! July 1 deadline to apply for EHR hardship exemption

Penalties loom for eligible professionals (EPs) who are unable to successfully participate in the CMS Electronic Health Records (EHR) Incentive Program by July 1 and for EPs who participated in calendar year (CY) 2011 or 2012 but not in 2013. These EPs may receive a 1 percent penalty on their total Medicare Part B fee-for-service payment amount in CY 2015. Read more about the EHR Hardship Exemption.

Master general surgery coding workshop August 20–22

Space is still available to attend the next ACS coding workshop, August 20–22 at the Lowes Vanderbilt Hotel in Nashville, TN. This fast-paced three-day workshop is geared toward surgeons and their staff who want their coding and reimbursement skills to match the quality of their clinical care. This year, the College included a full day of 10th revision of the International Statistical Classification of Diseases (ICD-10). During this portion of the program, instructors take a systematic approach to deconstructing the ICD-10 guidebook. The remainder of the course focuses on mastering general surgery Current Procedural Terminology with an? in-depth analysis of neoplasms, GI complaints and conditions, skin lesions, non-healing wounds and signs and symptoms. Register for our coding workshops. Download our ICD-10 fact sheet.

At the State Level

Optometry scope expansion signed into law in Louisiana

On June 5, Louisiana Gov. Bobby Jindal (R) signed H.B. 1065, which expands optometry's scope of practice to include scalpel and laser surgery and injections.

The new law allows optometrists to:

  • Inject anesthesia into the eyelid for surgical procedures
  • Perform scalpel eyelid surgeries on lesions, cysts, chalazia, and pterygia
  • Use lasers for glaucoma—selective laser trabeculoplasty (SLT) and argon laser trabeculoplasty (ALT)
  • Perform yttrium aluminum garnet (YAG) posterior capsulotomy
  • Insert needles for paracentesis procedures

The College worked closely with the Louisiana Chapter of the ACS as well as other specialty societies to oppose this legislation, which included sending a letter to Governor Jindal asking him to veto the legislation as well as sending action alerts to Louisiana Fellows, which resulted in more than 100 messages being sent to Governor Jindal. If you have any questions about this legislation, please contact ACS State Affairs staff at

Youth concussion prevention efforts progress in four states

Efforts to prevent the harmful effects of youth concussions continue to advance in state legislatures. In the last month, four more states passed legislation aimed at various components of youth concussion prevention and treatment.

On May 28, New Hampshire Gov. Maggie Hassan (D) signed H.B. 1113, which establishes a definition of head injury and requires school districts to distribute a concussion and head injury information sheet to student-athletes.

In Illinois, the legislature recently passed H.B. 5431, which requires an online certification program to be developed on concussion awareness and reduction of repetitive subconcussive hits and concussions. This online concussion certification will be mandatory for high school coaching personnel, including the head and assistant coaches and the athletic directors. The Governor has not signed the bill.

Legislation recently passed in Rhode Island, H. 7367/S. 2181, would require teachers and school nurses to complete a low- or no-cost training course and an annual refresher course in concussions and traumatic brain injuries.

In California, both the Senate and the Assembly have passed A.B. 2127, legislation that would limit full-contact football practices and require a student-athlete who has suffered a concussion or head injury to complete a graduated return-to-play protocol of at least seven days, as specified.

If you have any questions about any of these bills, contact ACS State Affairs staff at

Trauma funding included in Michigan Appropriations Bill

Until recently, Michigan was one of only a handful of states without a funded trauma care system. Despite passage of legislation and rules to support such a system in 2004 and 2007, no funding was allocated to hire and train staff, set up a registry to collect patient data, and implement programs until 2010. Since 2011, $3.5 million in funding from the Crime Victims Fund was earmarked to develop Michigan's trauma system. This money is scheduled to begin to sunset this year, with only 50 percent of the original amount allowed to be used for the trauma system moving forward, unless additional action is taken.

In response, Sen. Roger Kahn (R-32) led an effort to fund the development of the trauma system through tobacco taxes and then through the regular appropriations process. The initial funding request was $10 million, but revenue estimates were revised downward during the appropriations process, which lowered the amount included in the final budget to $1.3 million. The budget bill, H.B. 5313, was signed by Gov. Rick Snyder (R-MI) on June 13.

Strong advocacy efforts stymie legislation in New York

Several bills that would have negatively affected the medical community were stymied as a result of increased physician-led advocacy efforts during the recent legislative session in New York. Although the bills may be introduced in 2015, successful lobby efforts on May 20 helped to hinder efforts to increase medical liability rates and scope of practice infringement. Contact Justin Rosen, State Affairs Associate, for details.

Massachusetts trauma registry

The Massachusetts Senate and House approved budget amendments to fund a state trauma registry in fiscal year 2014–2015, as well as the funding for the creation of 1.5 staff positions. However, two versions of the state budget must be approved by a six-person conference committee. Nonetheless, the amendments are expected to receive full legislative approval. The Massachusetts Chapter of the ACS and members of the Committee on Trauma have been strong advocates for these funds. If you have any questions concerning the budget, contact ACS State Affairs staff at

Uncompensated care in Medicaid expansion states

According to a report from the Colorado Hospital Association, rates for uncompensated care in Medicaid expansion states have decreased dramatically since January. In studying 465 hospitals spanning 30 states, the study found that uncompensated care decreased by 30 percent in Medicaid expansion states. Although it is too early to tell if these savings will be enough to cover the cost of the overall Affordable Care Act implementation, the correlation is still interesting.

PAC and Grassroots

Plan an in-district meeting with your members of Congress

As the 2014 election season gets under way and Congress recesses for the summer, now is the time to schedule in-district meetings with your elected officials to begin building the important relationships that will advance the ACS advocacy and health policy agenda. U.S. representatives and senators are scheduled to be in their home districts June 30 through the July 4 weekend and the entire month of August.

Use the SurgeonsVoice Advocacy Handbook on to guide you through this process. also includes helpful issue briefs on relevant topics, such as Medicare Physician Payments/SGR, the 96-Hour Rule, and Ensuring Access to Trauma Care.

These meetings should assist in establishing long-term relationships and in positioning you as a trusted advisor on health care issues. You are encouraged to pair with other surgeons and surgical residents in your area. Take a photo with your member of Congress and share it with the ACS Division of Advocacy and Health Policy (DAHP). ACS staff will work with you to ensure members understand that you are advocating on their behalf. If you have any questions or concerns after reviewing the materials on, contact Sara Morse, American College of Surgeons Professional Association Political Action Committee (ACSPA-SurgeonsPAC) and Grassroots Manager, and Kaitlyn Dwyer, ACSPA-SurgeonsPAC and Grassroots Assistant, or call 202-337-2701.

Other News of Interest

  • On June 3, ACS regulatory staff attended an industry health care provider roundtable discussion on the PPSA described previously. Hosted by PhRMA, AdvaMed, and BIO, the meeting included discussions on industry and provider readiness, the registration process, the Open Payments website, Phase II reporting, the dispute resolution process, and the scheduled release of Open Payments data in September.
  • The Surgical Quality Alliance (SQA) hosted its second meeting of the year on June 17 in Washington, DC. Managed by ACS DAHP staff, topics for this meeting included cost transparency, clinical data and health information technology, patient-reported outcome measurement, Qualified Clinical Data Registries, and surgical quality measurement.
  • On June 19, ACS regulatory staff attended the Bipartisan Policy Center forum Delivery System Reform: Transitioning from Volume to Value. Remarks on improving quality and value were made by Dr. Patrick Conway, Deputy Administrator for Innovation and Quality and Chief Medical Officer of CMS, and Bob Henkel, CEO of Ascension Health. Following these formal remarks, a panel of health policy experts held an informal discussion on the future of providers as they transition into alternative payment and delivery models.
  • The ACS hosted a Surgical Coalition meeting on June 25 discussing relevant issues that affect an array of specialties such as state exchanges and coverage issues, meaningful use, nondiscrimination, impact of the Supreme Court ruling on Hobby Lobby's challenge to the contraception mandate in Obamacare, and more. The Surgical Coalition represents more than 20 surgical specialty anesthesiology organizations; its primary objective is to harness collaborative advocacy strength to address federal legislation and regulations of common interest and concern to SQA members.

For more frequent updates, follow the ACS on Twitter, like the ACS on Facebook, or add the advocacy Web section to your "favorites" list. Send questions or comments about this issue of The ACS Advocate to Chantay P. Moye, Communications Manager, at