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

Bulletin Advocacy Brief: October 21

Advocacy in Action

Check out ACSPA Virtual Engagement Opportunities Surrounding Clinical Congress 2021

During the virtual Clinical Congress 2021, attendees will have the opportunity to visit the American College of Surgeons Professional Association (ACSPA) SurgeonsVoice and SurgeonsPAC information booth in ACS Central to learn more about the College’s grassroots and political programs, including how to become more involved.

The ACSPA political action committee, ACSPA-SurgeonsPAC, will also host various activities for eligible members and SurgeonsPAC contributors, including a nonpartisan 2022 midterm election update with Nathan L. Gonzales, editor and publisher, Inside Elections, plus a special event featuring guest speaker Adam Steltzner, leader and chief engineer, NASA Mars 2020 Mission.

To learn more, contact surgeonspac@facs.org.

SurgeonsVoice Advocate of the Year Update

The ACS Division of Advocacy and Health Policy’s (DAHP) Advocate of the Year recognition program actively monitors surgeon advocate participation in SurgeonsVoice activities, including responding to legislative “Calls to Action,” utilizing tools and resources, and engaging policymakers. Top participants also work to actively build and maintain relationships with legislators, helping to advance critical ACS-supported advocacy and health policy priorities.

While the 2021 Advocate of the Year will be recognized at the virtual Clinical Congress 2021 in the Annual Business Meeting of Members, 5:00 pm Central time Wednesday, October 27, the following Fellows are top contenders as of October 18:

  • Marion C. W. Henry, MD, MPH, FACS, FAAP
  • Amalia L. Cochran, MD, FACS
  • Mark A. Dobbertien, DO, FACS
  • James W. Fleshman, MD, FACS, FASCRS
  • Nancy L. Gantt, MD, FACS
  • Steven Schechter, MD, FACS
  • Hunter B. Wessells, MD, FACS

For more information and to review past recipients, visit the Advocate of the Year web page. To learn more about your personal advocacy engagement, contact Maggie Draughn at mdraughn@facs.org.

On the Hill

Bipartisan Majority of the U.S. House of Representatives Calls for Action to Stop Medicare Payment Cuts

Representatives Ami Bera, MD (D-CA), and Larry Bucshon, MD (R-ID), along with 245 bipartisan members of the U.S. House of Representatives, sent a letter to Speaker Nancy Pelosi (D-CA) and Leader Kevin McCarthy (R-CA) last week urging congressional action on imminent Medicare payment cuts before the end of the year. The letter highlights growing financial uncertainty within the Medicare payment system and the need for systemic reforms to the payment system to speed the transition to value-based care. It also urges Congress to provide stability to health care professionals by averting imminent payment cuts, including extending the expiring 3.75 percent payment adjustment Congress provided last year.

The overwhelming support for the letter is the product of vigorous grassroots efforts by surgeon advocates across the country and sends a clear message to House leadership that Congress must act to avert the Medicare payment cuts this year.

For more information, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at czlatos@facs.org.

Key Congressional Champions Leading Sign-on Letter to Biden Administration on Surprise Medical Billing

In December 2020, Congress passed the No Surprises Act, which bans balance billing for out-of-network services and includes an impartial payment dispute resolution process. While the law requires all factors to be considered equally in arbitration, the Administration’s interim final rule establishes a presumption that the median in-network rate, calculated by insurance companies, is the appropriate payment rate – regardless of other factors. The recent regulation ignores years of bipartisan and bicameral negotiations and misreads congressional intent, heavily benefiting insurers over physicians.

Because of this, Representatives Tom Suozzi (D-NY) and Brad Wenstrup, DPM (R-OH), are leading a congressional sign on letter to the Departments of Health and Human Services, Treasury, and Labor urging them to align the law’s implementation with the legislation Congress passed to ensure it is reflective of congressional intent. The letter also highlights the development of the law through a comprehensive process that included hearings, markups, and extensive negotiations, which resulted in Congress rejecting a benchmark rate and determining the best path forward for patients was to authorize an open negotiation period coupled with a balanced Independent Dispute Resolution (IDR) process. This IDR process required the equal consideration of relevant information presented by either party except for billed charges and public payer information, capturing the unique circumstance of each billing dispute without causing any single piece of information to be the default one considered. The ACS supports the Wenstrup-Suozzi sign-on letter effort and urges all members of the U.S. House of Representatives to sign on in support.

To take action, visit SurgeonsVoice and ask your representative to sign the letter by the October 29 deadline.

For more information, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at czlatos@facs.org.

Prior Authorization Legislation Introduced in U.S. Senate

On October 20, Senators Roger Marshall, MD (R-KS), Kyrsten Sinema (D-AZ), and John Thune (R-SD), introduced the Improving Seniors’ Timely Access to Care Act, S. 3018, which would improve transparency and efficiency in the prior authorization (PA) process in Medicare Advantage (MA) plans. The ACS is concerned about the growing administrative burdens and the delays in medically necessary care associated with excessive PA requirements. The ACS strongly supports this legislation, which would facilitate electronic prior authorization, improve transparency, and increase Centers for Medicare & Medicaid Services oversight on how MA plans apply PA requirements. Additionally, the bill would ensure PA requests are reviewed by qualified medical personnel and protect beneficiaries from disruptions in care due to PA requirements as they transition between MA plans.

Visit SurgeonsVoice and urge your Senators to cosponsor the Improving Seniors Timely Access to Care Act.

For more information, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at czlatos@facs.org.