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

Bulletin Advocacy Brief: November 18

Advocacy in Action

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

The SurgeonsVoice action center is consistently updated to reflect developments regarding American College of Surgeons (ACS)-supported legislative priorities. Thus, it is important for surgeon advocates to regularly visit SurgeonsVoice online to become educated, take action, and make an impact.

The following are current SurgeonsVoice calls to action, including new or updated priorities noted in bold:

If you haven't already, take action today. Note: Calls to action, or "campaigns," target various audiences based on the current "ask," so if you don't see one or more of the campaigns listed previously, your lawmakers are not intended targets for that specific effort.

To learn more about ACS Division of Advocacy and Health Policy-identified federal issues, visit the federal advocacy web page on the ACS website or contact staff at ahp@facs.org. For brief snippets of information about important advocacy-related activity, follow @SurgeonsVoice on Twitter.

ICYMI: SurgeonsPAC Maintains 2022 Midterm Elections Partnership

SurgeonsPAC partners with Nathan Gonzales, editor and publisher of Inside Elections, to receive nonpartisan analysis and remain educated about important election trends and emerging races across the country. This includes information pertaining to House, Senate, gubernatorial, and presidential campaigns, plus a SurgeonsPAC-branded monthly publication with race ratings, candidate conversations, and other key updates circulated to PAC members.

As a reminder, SurgeonsPAC only supports candidates seeking federal office, and 2021 contributions can be viewed at www.surgeonspac.org/disbursements (login required). The PAC does not fund state/local or presidential campaigns.

To review the latest issue, visit Inside Elections. For more information about SurgeonsPAC partnerships and opportunities to engage, contact staff at surgeonspac@facs.org.

Contributions to ACSPA-SurgeonsPAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of ACSPA have the right to refuse to contribute without reprisal. Federal law prohibits ACSPA-SurgeonsPAC from accepting contributions from foreign nations. By law, if your contributions are made using a personal check or credit card, ACSPA-SurgeonsPAC may only use your contribution to support candidates in federal elections. All corporate contributions to ACSPA-SurgeonsPAC will be used for educational and administrative fees of ACSPA and other activities permissible under federal law. Federal law requires ACSPA-SurgeonsPAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. ACSPA-SurgeonsPAC is a program of the ACSPA, which is exempt from federal income tax under section 501c (6) of the Internal Revenue Code.

Help Amplify Support for MISSION ZERO in Congress

The ACS sent a letter on November 2 to leadership of the House and Senate Committees on Appropriations requesting that report language regarding MISSION ZERO funding remain a priority for inclusion in year-end spending legislation. Both the House and Senate included report language in the Labor-Health and Human Services, Education, and Related Agencies (L-HHS) bills directing $5 million in funding for the Trauma Readiness Grant Program established by the MISSION ZERO Act. The grants would defray the administrative costs incurred by trauma centers to embed military trauma professionals into civilian trauma centers. The military-civilian trauma care partnerships funded by the grant will allow military teams and surgeons to gain exposure to treating critically injured patients, thus increasing readiness for when these units are deployed.

Call to Action: As surgeons and constituents ACS needs your help to amplify this critical ACS-supported issue! To ensure this important program remains a top priority for Congress, please encourage your lawmakers to support MISSION ZERO and thank those who have already pledged their support!

Act now

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

On the Hill

President Biden Nominates Robert Califf, MD, for FDA Commissioner

President Biden has nominated Robert Califf, MD, to serve as commissioner of the Food and Drug Administration (FDA). Dr. Califf is a cardiologist and a senior advisor at the Duke Clinical Research Institute, Durham, NC. Prior to his most recent positions at Verily and Google Health, Dr. Califf served as FDA Commissioner during the final year of President Obama's term (February 2016 to January 2017).

Sens. Joe Manchin (D-WV) and Richard Blumenthal (D-CT) have expressed opposition to Dr. Califf's nomination given his ties to the pharmaceutical industry. Califf was previously confirmed by the Senate in an 89-4 vote in 2016. A confirmation hearing has not yet been scheduled, but Dr. Califf's nomination will be considered by the Senate Health, Education, and Pensions Committee.

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

ACS Joins Letter in Support of Pediatric Device Consortia Grant Program

Last week, the ACS joined a coalition letter in support of the Pediatric Device Consortia (PDC) Grant Program at the Office of Orphan Products Development at the Food and Drug Administration (FDA). The PDC program provides grants to non-profit pediatric medical device consortia, which assist scientists and innovators, particularly small businesses, with technical and financial resources to improve the number of medical devices available to children.

Because pediatric populations pose significant challenges for device manufacturers, including differences in size, weight, and metabolism rate, the development and release of medical devices for children often lags five to 10 years behind those for adults. The PDC program has been successful in helping to address this problem, assisting in more than 2,000 proposed pediatric medical device projects. The letter thanks the bipartisan leaders of the Senate Appropriations Committee for including $7 million in funding for the program in the chamber's fiscal year 2022 funding proposal for the FDA and urges Congress to adopt that funding level in its final appropriations bill.

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

Regulatory Updates

CMS Releases CY 2022 OPPS/ASC Final Rule

The Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) payment rule on November 2.

In last year's CY 2021 OPPS/ASC rule, CMS finalized a policy to eliminate the Inpatient Only (IPO) list—which includes services that can be safely provided only in an inpatient setting—over the course of three years and removed 298 codes from the list in the first year of the transition. In response to extensive advocacy efforts undertaken by the ACS and other medical specialty societies in opposition of this policy, CMS has decided to retract such policy and maintain the IPO list. The agency will stop the phased elimination of the IPO list and restore the 298 codes back to the IPO list beginning in CY 2022. CMS also finalized the adoption of a process through which stakeholders may nominate surgical procedures to be covered in ASCs.

In addition, the final rule includes updates to quality measures within the Outpatient Quality Reporting program and the Ambulatory Surgery Center Quality Reporting program. The agency also shared feedback and discussed its efforts to build on priorities to close health equity gaps in quality incentive programs and to drive these programs towards full utilization of digital quality measures in coming years.

The ACS is evaluating these and other proposals to determine the impact on surgery. The final rule and related fact sheet are available online for public review. Contact regulatory@facs.org with questions.

Medicare Care Compare Doctors and Clinicians Preview Period Now Open

The Medicare Care Compare Doctors and Clinicians Preview Period opened November 15 and will remain open through 8:00 pm ET on December 14, 2021. Surgeons can now preview 2020 Quality Payment Program (QPP) performance information before it is posted on clinician and group profiles on Medicare Care Compare and in the Provider Data Catalog (PDC). Previews can be accessed by logging into the QPP portal using HARP credentials. If the physician or group is eligible to opt out of having their 2020 performance information publicly reported, an opt-out option will be available on the Doctors and Clinicians Overview page in their QPP portal.

CMS offers the following resources to learn about the 2020 QPP performance data information available for preview and the 2019 clinician utilization data that will be added to the PDC:

If physicians or groups have questions about the preview or the QPP information to be posted, contact the QPP Service Center at 1-866-288-8292 or e-mail QPP@cms.hhs.gov.

Additional questions can be directed to QualityDC@facs.org.

CMS Announces Automatic COVID Exemption from MIPS for 2021

CMS recently announced that they will apply the automatic extreme and uncontrollable circumstances (EUC) policy to all individual Merit-based incentive payment system (MIPS) eligible clinicians for the 2021 MIPS performance year due to the continued effects of the COVID-19 pandemic. Under the automatic EUC policy, CMS will automatically reweight all MIPS performance categories—Quality, Improvement Activities, Cost, Promoting Interoperability—to 0 percent, which will result in a neutral payment adjustment for the 2023 MIPS payment year unless the individual submits data for 2 or more MIPS categories. Note that that this policy will not apply to those who participate in MIPS via groups or those who are part of an Alternative Payment Model (APM). The automatic reweighting also will not be applied if the individual is part of a group or APM entity that submits data on their behalf and receives a higher score.

For more information, review the 2021 MIPS Automatic EUC Policy fact sheet. Further questions can be directed to QualityDC@facs.org.