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

ACS Urges White House to Waive Cost-Sharing Requirements for Colonoscopy Screening

The American College of Surgeons (ACS) recently signed on to a letter to President Trump urging the U.S. Department of Health and Human Services to waive cost-sharing requirements when Medicare patients have precancerous polyps removed in a preventative colonoscopy as the department develops the 2020 Medicare Physician Fee Schedule final rule.

At present, Medicare waives coinsurance and deductibles for preventative colonoscopies. However, when a polyp is discovered and removed, the procedure is reclassified as therapeutic for the purposes of Medicare billing, and patients are required to pay coinsurance charges. Not only is this cost-sharing obligation confusing to patients, it also results in the unintended consequence of creating a financial barrier to the most effective method of colorectal cancer prevention.

Several physician, patient advocacy, oncology, and cancer organizations, including the American Cancer Society, signed the letter, which builds on the College’s longstanding and ongoing advocacy on this issue, including support for the Removing Barriers to Colorectal Cancer Screening Act, H.R. 1570/S. 668.

For more information, contact Amelia Suermann, ACS Congressional Lobbyist, at asuermann@facs.org.

Congress Urges CMS to Partner with Stakeholders on Quality Measurement

Last week, key members of Congress sent a letter to the Centers for Medicare & Medicaid Services encouraging the agency to work with stakeholders to develop and implement quality measures that go beyond payment decisions and drive value. The letter focuses on the shortcomings of the Merit-Based Incentive Payment System Quality component and its ability to meaningfully measure quality for all physicians. At present, many hospital-based surgeons are being evaluated on their compliance with primary care measures instead of the quality of the surgical care patients receive. The letter highlighted that a strong quality measurement framework should consider meaningful measures that focus on high-value processes, clinical outcomes, and patient-reported outcomes or experiences to inform quality improvement and better outcomes for patients.

For more information on the American College of Surgeons (ACS) perspective on this issue, read the July issue the Bulletin. For more information on this letter, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at czlatos@facs.org.

ACS and Other Physician Organizations Send Letter to CMS on Reducing Prior Authorization Burdens

The American College of Surgeons (ACS) joined the American Medical Association and other physician organizations in sending a letter to the Centers for Medicare & Medicaid Service (CMS) regarding the agency’s Patients Over Paperwork initiative, which is focused on efforts to reduce administrative burdens in health care. The letter emphasizes concerns regarding the agency’s sole focus on automation as a means for implementing prior authorization (PA) reforms. Although automation is important, it is only one component of needed reforms to reduce the burdens of burdensome PA requirements.

In addition to enhancing the interoperability of PA, the letter urges CMS to address the numerous other process flaws associated with PA. The letter strongly urges CMS to implement a comprehensive strategy to reduce the repercussions and burdens associated with PA requirements by facilitating payor adoption of the following principles in addition to automation: selective application of PA to outliers, review/adjustment of PA lists to remove services/drugs that represent low-value PA, transparency of PA requirements and their clinical basis, and protections of patient continuity of care.

For more information on ACS efforts to address administrative burden and PA requirements, contact Lauren Foe, ACS Senior Regulatory Associate, at lfoe@facs.org. For more information on congressional activity on prior authorization, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at czlatos@facs.org.

Register Now for Course on Keys to Success for Employed Surgeons at Clinical Congress

Surgeons who are either employed or considering becoming employed by a hospital or health system will benefit from a new Didactic Course, Keys to Success for Employed Surgeons, 8:30 am–12:45 pm October 30 at Clinical Congress 2019 in San Francisco, CA. The demand for surgeons in the institutional setting is rising, and it is critical that they be well-versed in the various aspects of employment. Unfortunately, guidance available to surgeons on employment is extremely limited.

This course is a unique opportunity for Fellows and Resident Members of the American College of Surgeons (ACS) to have access to leaders in national physician recruitment, health care law, and surgeons with expertise in compensation packages in an ideal forum for sharing of best practices on how to review and negotiate terms of employment. Participants will earn 4 hours of Continuing Medical Education credit.

Learning objectives include the following:

  • Learn how to value your services within your local market
  • Learn your rights, duties, and obligations as an employee in the institutional workplace
  • Learn how to interpret employment contracts and gain the skills needed to advocate for yourself during the negotiation process
  • Learn how to navigate the various physician compensation packages and payment models that hospitals and health systems offer

Registration for this course is required. Space is limited, so early registration is recommended. Register today.

This course is sponsored by the ACS Division of Advocacy and Health Policy and the General Surgery Coding and Reimbursement Committee. For additional information, contact Lauren Foe at lfoe@facs.org.

Reminders and Updates on ACS SSR MIPS 2019 ParticipationSurgeon Specific Registry

The American College of Surgeons (ACS) Surgeon Specific Registry (SSR) allows you the option to participate in the Centers for Medicare & Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS), which is available in the SSR for the 2019 performance year. Submitting MIPS 2019 data to CMS will allow you to potentially avoid either a flat 7 percent negative payment adjustment or earn a positive payment adjustment of up to 7 percent in calendar year 2021.

To participate, first verify your MIPS 2019 Initial Eligibility via the CMS QPP Participation Status lookup tool by entering your individual surgeon National Provider Identifier (NPI) number before signing up for MIPS 2019 in the SSR. Verify your MIPS 2019 Final Eligibility again in November 2019, which is when CMS finalizes eligibility data. Visit the ACS SSR website for more information about MIPS 2019 participation, including requirements, measures and Improvement Activities (IA) specifications, and educational resources.

The deadline to submit your MIPS 2019 data through the SSR is January 3, 2020.

The SSR is supporting the Quality and IA components of MIPS 2019, and CMS recognizes submitting MIPS data through the SSR as individual, registry-based reporting. MIPS 2019 Clinical Quality Measures reporting includes options for general surgeons and plastic surgeons in addition to a range of other surgical specialties. For MIPS 2019 IAs, surgeons have 88 surgically relevant activities to choose from for attestation, including two new opioid-related IAs.

Furthermore, several MIPS 2019 educational and instructional resources, including quick guides and video demonstrations, are available online on the ACS SSR website.

For any SSR programmatic questions, including MIPS participation, contact the ACS SSR Program at SSR@facs.org, or at 312-202-5408. For SSR technical questions or issues (password reset, account reactivation, and so on), contact Technical Support at ACSTechSupport@iqvia.com or at 877-600-7237 (toll-free).