We’re reaching the tipping point. The sequester is scheduled to take effect March 1 if Congress and The White House can’t find a bipartisan solution that prevents deep spending cuts. Health care cuts in the sequestration include a 2 percent cut in Medicare physician payments; cuts to graduate medical education (GME); and cuts to the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA), among other areas. The 2 percent cut to physician payment rates is separate and distinct from the annual SGR cuts, which Congress managed to avert this past January.
At press time, the U.S. Senate was planning to vote on a Democratic plan that promises $110 billion in alternative revenues and savings to buy time to work out a larger deficit deal including at least corporate tax reform. The prospects for the bill depend heavily on Majority Leader Harry Reid’s (D-NV) willingness to open his bill to floor amendments that might gain traction with swing Republicans whose votes are needed for passage. The outlook was unclear and it was likely that the cuts would go into effect. The precise percentage cuts will not be known for sure until March 1, but about $70 billion in 2013 budget authority would be wiped out, with defense expecting to face a 7.7 percent reduction and nondefense about 5.2 percent. The American College of Surgeons (ACS) has repeatedly warned Congress that these cuts could damage access to health care.
This week, the ACS responded to a joint proposal from the U.S. House Committee on Ways and Means and the House Committee on Energy and Commerce that calls for permanently repealing the SGR formula and reforming the Medicare physician payment system. The ACS asserts that any new payment system should be based on the complementary objectives of improving outcomes, quality, safety, and efficiency while simultaneously reducing the growth in health care spending. In order for any alternative payment system to be successful, the ACS and other organizations believe it should meet the following objectives: ensure that quality and safety are the highest priorities; require that specific quality metrics are achieved before any savings can be shared among the payor or the providers; maintain primacy of physician-leadership within a highly qualified team of health care professionals to work with patients in determining evidence-based courses of clinical care; acknowledge that surgical care is delivered in a variety of geographical locations and facilities; allow for innovative responses that may be required to address patient needs in urgent or unique situations; and preserve the ability of a surgeon to recommend the surgical treatment plan that best meets the patient’s needs as guided by best practices and evidence-based medicine. In the weeks ahead, the ACS will provide details on the impact of the payment cuts and what it means long-term for surgery. View sequestration overview.
INSIDE THIS ISSUE
At the Federal Level
Leadership and Advocacy Summit Overview
At the State Level
Definition of Surgery | Tort Reform | Attorneys Get Pay Raises | Legislative Action
PAC and Grassroots News
The Advocacy Summit and the ACSPA-SurgeonsPAC
Other News of Interest
AT THE FEDERAL LEVEL
2013 ACS Leadership and Advocacy Summit overview
Register today to attend the ACS annual Leadership and Advocacy Summit, April 13–16, at the Mandarin Oriental Hotel in Washington, DC. In its second year, the Leadership and Advocacy Summit takes place at a time when the College is celebrating a century of successful stewardship of improving the care of the surgical patient and safeguarding standards of care. This dual meeting supports the College’s goals of bringing established and aspiring leaders together in a forum to discuss common issues and challenges facing surgery and providing a platform to engage policy makers on issues critical to surgeons and the quality of care for surgical patients.
In order to do that, leadership and advocacy efforts must be transparent and effectual enough to evoke change. Members are encouraged to attend the meeting, not just this year, but every year to demonstrate solidarity and credibility.
Advocacy Summit, April 14–16
A host of well-known health policy and political experts are scheduled to speak during this year’s Summit, including Pulitzer Prize–winning Washington Post journalist and bestselling author Bob Woodward. Mr. Woodward will speak at the Summit’s keynote dinner on Sunday, April 14. He has a reputation for being candid and straightforward about the leaders he has observed, and explores with audiences the successes and failures of Presidents from Nixon to Obama. Monday, April 15, chief White House correspondent for Politico, Mike Allen, and renowned health care policy expert Gail Wilensky, PhD, will speak. The New York Times dubbed Mr. Allen “The Man the White House Wakes Up To.” Mr. Allen is also the creator of the daily newsletter Morning Money, which gives readers insight into the intersection of Washington and Wall Street. Dr. Wilensky is an economist and senior fellow at Project HOPE, an international health foundation. She also develops and analyzes policies relating to health care and the economy.
“Lobby day” is April 16, when participants meet with their respective members of Congress and advocate on behalf of surgeons. Participants will receive in-depth briefings on critical issues; learn how to effectively manage a meeting when visiting a congressional office; learn how to advocate in their home state; and become a trusted resource on relevant issues important to surgery and the surgical patient, including physician payment reform, physician workforce, and trauma issues.
To connect with colleagues and encourage dialogue, a welcome reception will take place prior to the keynote dinner on Sunday, April 14, and a second reception will take place on Monday, April 15.
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Leadership Conference, April 13–14
Immediately prior to the Advocacy Summit, the Leadership Conference will take place April 13–14. Highlights of the meeting include a panel presentation on Sunday morning, April 14, featuring Young Fellows Association (YFA) leaders S. Rob Todd, MD, FACS, speaking on Getting Young Fellows Involved with the College, and Steven Li-Wen Chen, MD, FACS, reporting on the success of the YFA mentorship program. Also included in the lineup of panel presenters will be David Dexter, MD, FACS, presenting on Best Practices for Chapters. Another Sunday morning session will include a discussion of the specific roles and responsibilities of leaders at the College, including Regents, Governors, and Chapter Officers. John Rioux, MD, FACS, Chair of the ACS Governors Committee on Chapter Relations, will be among the speakers at this session and will address the responsibilities of a Chapter Officer. On Sunday afternoon, conference attendees will convene by geographic location, allowing participants to identify areas for synergy and unified efforts. The Leadership Conference will end with participants sharing what they discussed during the afternoon.
Detailed agendas for the Leadership and Advocacy Summit will be released soon. Meanwhile, register today and learn about housing information.
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AT THE STATE LEVEL
Florida legislature to address definition of surgery
In an effort to enhance quality eye care for Florida citizens, HB 443 was introduced in the current legislative session by Rep. Jeanette M. Nunez (R) to adopt a definition of surgery to clarify what optometrists may or may not do as part of their scope of practice. Optometrists will be required to report to the Florida Department of Health adverse incidents in the practice of optometry, and a patient-specific written protocol will be required between an ophthalmologist and an optometrist for the provision of postoperative care. View HB 443
Constitutional amendment on tort reform in Arkansas
The Arkansas Senate is considering Senate Joint Resolution 2 (SJR2), introduced by Sen. Jeremy Hutchinson (R), which would amend the state’s constitution to address various elements of tort reform. SJR2 includes the following requirements: individuals who file a lawsuit that is dismissed as frivolous must pay court costs up to a certain amount; expert witnesses must be of the same specialty as the defendant; a certificate of good faith must be filed with the complaint; a suit cannot commence until at least 60 days after written notice of claim for medical injury has been served; and punitive damages are limited to not more than nine times the amount of compensatory damages. View Joint Senate Resolution 2.
Illinois plaintiff attorneys get pay raise
Illinois plaintiff attorneys received a substantial pay increase under legislation signed in January by Illinois Gov. Patrick Quinn (D). HB 5151 eliminated the sliding scale fee structure in medical liability cases and replaced it with a flat 33.33 percent fee on the entire award. Formerly, the sliding scale was 33.33 percent of the first $150,000, 25 percent of the next $850,000, and 20 percent of anything more than $1 million.
State legislatures get active
The majority of state legislatures are currently in session. Below are highlights of issues relevant to surgeons:
- A total of 72 bills have been introduced on trauma and injury prevention at the state level. Distracted driving bills prohibiting texting or use of handheld devices while operating a vehicle continues to be a trend in state legislation. States with bills to ban use of handheld devices while driving include AZ, GA, HI, IA, MD, ME, MS, NM, OK, and SC.
- Mississippi and Texas have both introduced the Uniform Emergency Volunteer Health Practitioner’s Act.
- Breast Density Mandate legislation is a huge trend right now in state legislation. This legislation requires health care practitioners to notify patients if they have dense breast tissue that shows up on mammograms and often requires insurance coverage for additional testing with ultrasounds or MRIs. Currently, 14 states are considering this legislation, and the list is expected to expand during the 2013 legislative session. The states considering this legislation are CT, FL, GA, HI, IA, IN, MD, MI, OR, PA, SD, TN, TX, and VA.
- Truth in Advertising bills were introduced in ND, NE, NJ, VT, FL, and NY.
- Medical liability reform legislation is seeing an uptick in state legislation this year; 23 bills have been introduced addressing a number of topics, such as caps on noneconomic damages, certificates of merit, “I’m sorry” laws, and expert witness qualifications. States with these types of bills include AK, AR, CT, HI, IA, MO, MS, MT, NY, OR, TN, and VA.
Surgeons seeking additional information on state legislative status should visit the College’s members only web portal.
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PAC AND GRASSROOTS NEWS
The Advocacy Summit and ACSPA-SurgeonsPAC
The American College of Surgeons Professional Association Political Action Committee (ACSPA-SurgeonsPAC) is pleased to be a part of this year’s ACS Leadership and Advocacy Summit described previously. This meeting brings together advocates, new and experienced, from across the country to meet with their members of Congress. As the political arm of the College that represents the needs of surgeons and surgical patients on Capitol Hill, the ACSPA-SurgeonsPAC can play a huge part in helping participants reach their advocacy goals. The ACSPA-SurgeonsPAC enables the College to develop relationships with Representatives and Senators to educate them about the issues that affect the surgical practice environment. Each year the ACSPA-SurgeonsPAC contributes to incumbents and candidates who act as champions for surgery, regardless of their party affiliation. The ACSPA-SurgeonsPAC is a non-partisan entity, and all U.S. members of the College are eligible to join.
ACSPA-SurgeonsPAC Advocacy Summit events
While at the Advocacy Summit, take time to stop by the ACSPA-SurgeonsPAC booth to learn more about how to get involved and to make a 2013 contribution. In conjunction with the Summit, there will be a Wine-Tasting Fundraiser and Raffle benefiting ACSPA-SurgeonsPAC on Monday evening, April 15, where you will have the chance to mingle with members of Congress and colleagues.
A minimum PAC contribution of $250 ($50 for residents) will grant entrance to the ACSPA-SurgeonsPAC wine-tasting fundraiser and automatically enter you to win a number of great prizes. The higher the contribution, the more times a participant will be entered to win. Previous 2013 PAC contributions of $1,000 or more will be credited toward wine tasting and raffle entry.
Space is limited. Summit registrants watch for the invitation coming soon.
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OTHER NEWS OF INTEREST
- Today, February 28, is the last day eligible providers may register and attest to meaningful use of Medicare Electronic Health Records (EHR) and receive an incentive payment for 2012. Learn more about ACS EHR efforts and attestation.
- Read the Bulletin online. In nearly every issue you will find an article on what surgeons should know about concerning regulatory topics, as well as a column on practice management.
- Meet members of the regulatory team in Las Vegas, NV, for the next ACS surgical coding workshop, March 7–8, at the Encore at Wynn Las Vegas. Register today.
- LIKE ACS on Facebook or FOLLOW ACS on Twitter
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