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

Bulletin Advocacy Brief: February 10

On the Hill

ACS-Led Coalition Urges Key Committee Hearings on Future of Medicare Physician Payment

The American College of Surgeons (ACS), along with 23 additional organizations representing surgeons and anesthesiologists, sent a letter to the chairs and ranking members of the Senate Finance Committee and House Ways and Means and Energy and Commerce Committees urging hearings on the ongoing structural problems with the Medicare Physician Fee Schedule and policies included in the Medicare Access and CHIP Reauthorization Act (MACRA).

While the ACS appreciates that Congress has intervened for the past 2 years to minimize the impact of drastic payment cuts, lawmakers must implement a long-term solution that will stabilize the system. The ACS remains committed to working with Congress to identify solutions that would address the long-term stability of the Medicare physician payment system and reform policies to help MACRA reach its intended goals of a sustainable value-based delivery system.

For more information, contact Carrie Zlatos, ACS Senior Health Policy Advisor, at czlatos@facs.org.

College Supports Comprehensive Funding Package to Support Cancer Research

The ACS joined a letter led by One Voice Against Cancer, a broad coalition of public interest groups representing millions of cancer patients, researchers, providers, survivors, and their families, urging Congress to pass a fiscal year 2022 government funding package as soon as possible.

A series of short-term funding measures are set to expire on February 18, creating uncertainty for government-supported cancer research, prevention, and treatment programs. Both the US House and Senate have proposed comprehensive funding bills that would increase funding for the National Cancer Institute and Centers for Disease Control and Prevention; however, these would not take effect as long as Congress continues to fund the government through short-term measures. Negotiations are ongoing on Capitol Hill, making it likely that another short-term extension will be needed after the February 18 deadline and may continue through the end of the year.

For more information, contact Emma Zimmerman, ACS Congressional Lobbyist, at ezimmerman@facs.org.

ACS Provides Feedback to Senate HELP Committee on Pandemic Preparedness

The US Committee on Health, Education, Labor and Pensions (HELP) has solicited feedback from the ACS and other stakeholders on the recently released draft legislation, the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics (PREVENT Pandemics) Act, authored by Senators Patty Murray (D-WA) and Richard Burr (R-NC), chair and ranking member of the HELP Committee.

The College’s submitted comments reflect lessons learned from the response to the COVID-19 pandemic, aiming for a robust, national infrastructure to support preparedness for future events. The ACS feedback focuses on ways to better coordinate medical services during a public health emergency or mass casualty event and suggests that language be included to establish an infrastructure that brings together emergency management and public health to enable timely response, resource sharing, and efficient casualty care. The ACS also notes the importance of real-time data sharing, and given the current blood shortage crisis, recommends that the HELP Committee consider the management of blood products as an essential element to any future response.

The ACS will continue working with the HELP Committee as it further refines the legislation and plans for future pandemics. For more information, contact Amelia Suermann, ACS Senior Congressional Lobbyist, at asuermann@facs.org.

State Affairs

States Looking at Gold Card Solutions for Prior Authorization

Legislators in several states are introducing bills to remove private insurance prior authorization (PA) barriers for physicians. Known as gold carding, used in legislation passed in Texas in 2021, the program provides that physicians who have a 90% PA approval rating over a 6-month period or given period for certain services will be exempt from PA requirements for those services. To date, gold card legislation has been introduced in Colorado (SB22-078), Indiana (HB 1271, HB 1046), Kentucky (HB 343), Mississippi (HB 780, HB 866/SB 2449), and Oklahoma (SB 1409).

Read a full list of PA bills being tracked by the ACS:

Prior Authorization State Legislation 2022

Commission on Cancer State Priority Issue: Expanding Coverage for Prostate Cancer Screenings

Each year, the Commission on Cancer (CoC) establishes state policy priorities; in 2022, one of those priorities includes expanding access to prostate cancer screenings through updates to existing standards and recommendations, such as age and patient history, as well as removing copays and other cost barriers.

According to the American Cancer Society, one in eight men living in the US will be diagnosed with prostate cancer during his lifetime. So far, only two states, Maryland and New York, have passed legislation to dismantle financial barriers to getting screened. As of this week, state bills specific to prostate cancer screening have been filed in California (A.B. 1520), Illinois (H.B. 1728), Virginia (H.B. 477), and New Jersey (A. 1278/S. 296 and S. 791).

Read a full list of cancer bills being tracked by the ACS:

Cancer State Legislation 2022

For more information on the legislation or to engage in state advocacy, contact Christopher Johnson, Manager, ACS State Affairs, at cjohnson@facs.org and Rebecca King, ACS State Affairs Associate, at rebeccaking@facs.org.

Regulatory Updates

2020 Quality Payment Program (QPP) Participation Information Released

The Centers for Medicare & Medicaid Services (CMS) recently released an infographic to share preliminary participation data for the 2020 Quality Payment Program (QPP). In 2020, the MIPS threshold was set at 45 points, meaning that Merit-based Incentive Payment System (MIPS)-eligible clinicians who scored at least 45.01 points will receive a positive payment adjustment in 2022.

Clinicians who scored 45.01–84.99 points will receive a 0.01% payment adjustment, and those who scored 85.00–100.0 points will receive a positive payment adjustment of up to 1.87%. Those who scored below 45.01 points will receive a negative payment adjustment of up to 9%. Preliminary participation information showed that 91% of MIPS eligible clinicians received a positive payment adjustment in 2020, with approximately 81% of clinicians receiving an exceptional payment adjustment. This marks the fourth year that the maximum positive payment adjustment clinicians can receive is below 2.0%.

The infographic also shares comparisons of group, individual, and small practice participation from 2019 to 2020. Surgeons with questions about this preliminary participation data should reach out to QualityDC@facs.org.

Advocacy in Action

SurgeonsVoice: Become Educated, Take Action, and Make an Impact

Members of Congress value feedback and guidance from constituents, particularly as they work to identify important priorities for the year ahead. Thus, the ACS strongly urges surgeon advocates to take an active role in advocacy by becoming more educated about and advocating for important ACS-supported priorities.

The SurgeonsVoice action center is regularly updated to reflect relevant issues that Congress is considering and allows surgeons to easily raise the profile of said issues, while further engaging with lawmakers to effect change. Currently, the following priorities are active on SurgeonsVoice:

To ensure timely updates, advocates are encouraged to review SurgeonsVoice action center profiles and ensure information, including mobile number, is current. Profiles can be accessed by expanding the drop-down menu (denoted by three horizontal lines in the top right corner), clicking the arrow next to “Hello, [First Name]!”, and selecting “Update Information.”

To learn more about ACS advocacy efforts, visit the federal advocacy web page or contact staff at ahp@facs.org. For brief snippets of information about important advocacy-related activity, follow @SurgeonsVoice on Twitter.