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

Bulletin Advocacy Brief: January 13

On the Hill

Congress Returns with High Stakes Agenda, Tight Deadlines

Lawmakers have returned to Capitol Hill for the second session of the 117th Congress, facing a busy agenda in a legislative year shortened by the approaching 2022 midterm elections. The Build Back Better tax and spending reconciliation package (H.R. 5376) remains stalled in the Senate due to objections from Sen. Joe Manchin (D-WV). Senate Majority Leader Chuck Schumer (D-NY) has expressed his intention for the Senate to vote on the bill this month. Congress faces a deadline of February 18 to maintain federal government funding for the remainder of the fiscal year, which ends September 30. Legislators do not appear close to an agreement on either total spending or a path forward for another stopgap spending bill or omnibus package.

Lawmakers also have started another round of talks on additional coronavirus relief given the surge in Omicron variant COVID-19 cases around the country. President Joe Biden is preparing a request to Congress for a separate, stand-alone COVID-related health spending package, expected to focus on therapeutics and vaccine distribution, while House Speaker Nancy Pelosi (D-CA) has suggested that there may be an opportunity to add federal coronavirus relief to the February 18 government funding legislation.

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

State Legislative Sessions Resume

State legislators across the country are returning to work as 2022 legislative sessions open. The College is actively reviewing and monitoring newly introduced legislation, as well as bills from 2021 sessions in the states that allow carry over into the new year. Of the approximately 750 bills being tracked, the College has identified bills to align state law with the federal No Surprises Act, including mirroring the federal independent dispute resolution among other components of the law, in Washington (S.B.5618/H.B.1688) and Maryland (SB180). By aligning the state laws with federal laws, these states can choose to further refine their laws and grant patients additional rights or protections. In addition, the ACS is monitoring a bill to streamline prior authorization (PA) for physicians with 90% PA approval rates in Indiana (H.B.1046).

Fellows can review the state legislation tracked by the ACS.

Additionally, grant funds are available for ACS State Chapters to engage advocacy on state legislation. Learn more about the Chapter State Advocacy Grant Program.

Advocacy in Action

SurgeonsPAC's Impact in 2021

Amid the challenges of 2021, SurgeonsPAC continued its work to elect and reelect federal policymakers, as well as educate key members of Congress on matters of importance to the ACS. SurgeonsPAC exists to help amplify ACS-supported federal advocacy priorities and establish strong relationships with lawmakers who are willing to advocate for surgical patients and surgery in Congress.

The following are examples of SurgeonsPAC efforts and successes last year:

2021 by the numbers

  • Welcomed 139 new donors
  • Attended more than 150 events to raise awareness about ACS-supported priorities
  • Led more than 15 fundraisers with key policymakers, inviting other specialty societies to further engage with these congressional advocates
  • Remained among the top 15 health professional PACs in Washington, DC
  • Contributed nearly $260,000 to more than 90 candidates, other PACs, and political campaign committees
  • Maintained nonpartisan, balanced disbursements to candidates, contributing 52% of funds to Democrats and 48% to Republicans
  • Garnered 100% participation from key advocacy groups within the College

Other efforts

  • Increased member visibility of the PAC via facs.org
  • Launched a year-long, “Did you know?” education campaign
  • Welcomed several new PAC Board members representing various specialties and regions
  • Facilitated another successful annual Board of Governors Pillar competition
  • Utilized the COT Advocacy Pillar Engagement Workgroup to amplify the PAC’s purpose
  • Increased donor recognition efforts through the SurgeonsPAC Monthly Recap, ACS publications, and various committee reports
  • Facilitated opportunities for ACS Fellows to meet with important congressional leaders willing to advocate for surgery and surgical patients
  • Organized opportunities for ACS Fellows to participate in local political events, serve in advisory capacities, or meet physician candidates running for Congress
  • Co-hosted the physician and dentist PAC forum with more than 60 health professionals in attendance to share fundraising and disbursement best practices, and educate and train health professionals interested in running for public office
  • Presented at several industry roundtables hosted by National Journal focused on raising and disbursing PAC funds in challenging political climates
  • Ensured PAC staff continue to serve in leadership roles among external healthcare industry groups, including an invitation to present at the Public Affairs Council 2022 National PAC Conference

To learn more about SurgeonsPAC, visit www.facs.org/advocacy/surgeonspac or contact surgeonspac@facs.org.

Regulatory Updates

MIPS 2021 Data Submission Is Open until March 31

The Centers for Medicare & Medicaid Services (CMS) has opened the data submission period for the 2021 Merit-Based Incentive Payment System (MIPS) performance year. The deadline to submit MIPS performance data is 8:00 pm ET on March 31, 2022. There are many ways to submit MIPS data to CMS, and the ACS suggests that surgeons stay in communication with any vendors—qualified registries, qualified clinical data registries (QCDRs), electronic health records (EHRs), and so on—that assist with their MIPS reporting and data submission to ensure all data requirements are met by the deadline. For individual surgeons who choose to report their MIPS data directly to CMS, they should:

  1. Go to the Quality Payment Program webpage
  2. Sign in using QPP access credentials
  3. Submit MIPS data for the 2021 performance period

CMS offers additional resources in the QPP Resource Library, including 2021 Data Submission FAQs. Surgeons can direct all additional questions to QualityDC@facs.org.

CMS to Suppress Certain MIPS Quality Measures for 2021 Performance Period

Beginning with the 2019 MIPS performance period, CMS implemented a “measure suppression policy,” which was created to ensure that clinicians are not penalized under MIPS if they had reported measures that have been significantly impacted by clinical guideline changes or other changes that may result in patient harm or misleading results.

What is happening? In accordance with this policy, CMS has determined that certain measures (view below table) will be excluded from a MIPS eligible clinician’s total measure achievement points - the quality category denominator—for the MIPS 2021 performance period/2023 payment year.

Quality Measure Number/Title

Collection Type Impacted

Suppression Rationale

Measure 111: Pneumococcal Vaccination Status for Older Adults 
  • Medicare Part B Claims
  • MIPS Clinical Quality Measures (CQM)
  • Electronic Clinical Quality Measure (eCQM) 
 
Updated Guidelines
Measure 117: Diabetes: Eye Exam
  • Medicare Part B Claims 
Quality Measure Implementation Resulting in Misleading Result
Measure 128: Preventative Care and Screening: Body Mass Index (BMI) Screening and Follow-up Plan
  • eCQM
Quality Measure Implementation Resulting in Misleading Result
Measure 134: Preventive Care and Screening: Screening for Depression and Follow-Up Plan
  • CMS Web Interface
Quality Measure Implementation Resulting in Misleading Result

What does this mean for you? When calculating the quality category score, the denominator will be reduced by 10 points for each of the noted measures a surgeon submitted during the 2021 MIPS performance period through the specified collection type. By reducing the overall denominator of the quality category, the measures submitted by the surgeon that are not suppressed will contribute a greater weight towards their quality score.

Surgeons can find more information about the measures suppressed for the 2021 performance period in the 2021 suppressed quality measures guidance document. Additional questions can be directed to QualityDC@facs.org.