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

Legislative and Regulatory Updates

Senate-Passed Infrastructure Package Awaits House Consideration

The Senate passed the $550 billion Infrastructure Investment and Jobs Act (H.R. 3684), known as the bipartisan infrastructure framework, by a vote of 69–30 August 10. The bill, which contains traditional infrastructure-related provisions to fund roads, bridges, transit, and broadband build-out, also includes health care provisions. House of Representatives action on the Infrastructure Investment and Jobs Act is not expected until mid-September when Congress returns from the district work period.

Health provisions in the bipartisan package include the following:

Make PPE in America

  • Any contracts for personal protective equipment (PPE) awarded by the Department of Homeland Security, the Department of Health and Human Services (HHS), or the Department of Veterans Affairs would have a minimum length of two years. The measure would require the products to be made in the U.S., except in limited circumstances. The bill also would allow the transfer of excess PPE from HHS to the Strategic National Stockpile (SNS), and allow for the sale of drugs, vaccines, medical devices, or other supplies from the SNS during a public health emergency.

Spending Pay-Fors

  • The bill would extend required cuts to mandatory spending—sequestration—for one year, through fiscal year (FY) 2031. It also would extend the 2 percent cap on sequestration from Medicare programs through FY 2031, with other appropriate changes to ensure all the savings are retained in the budget window. This provision accounts for $8.7 billion in savings.
  • Beginning January 1, 2023, the measure would require pharmaceutical manufacturers to provide refunds to the HHS based on the amount of Medicare Part B single-use drugs that were unused or discarded each quarter. Amounts would be deposited into the Federal Supplementary Medical Insurance Trust Fund. HHS would conduct periodic audits of the manufacturers and of claims submitted by providers and could impose civil monetary penalties on manufacturers that do not comply with the refund requirement. This provision accounts for $3 billion in savings.
  • The bill would prohibit HHS from implementing or enforcing a November 2020 final rule related to drug rebates before January 1, 2026. The rule generally prohibits plan sponsors under Medicare Part D or pharmacy benefit managers from receiving manufacturers' rebates. The moratorium on implementation of the rule saves $49 billion.
  • The measure would rescind $41.8 billion in unobligated coronavirus relief funds, while leaving unspent money in the Provider Relief Fund untouched.

For more information, contact Carrie Zlatos, ACS Senior Congressional Lobbyist, at

Engage in ACSPA Activities at the Virtual Clinical Congress 2021

The American College of Surgeons Professional Association (ACSPA) will host various virtual engagement opportunities for surgeon advocates and ACSPA-SurgeonsPAC contributors at the virtual Clinical Congress 2021. Clinical Congress attendees will have the opportunity to visit the SurgeonsPAC and SurgeonsVoice information booth to learn more about the College's grassroots and political programs, including how to become more involved. Specifically, participants can help leverage ACS-supported advocacy priorities by writing members of Congress or scheduling virtual visits with their representative or senators via SurgeonsVoice. Eligible members also can review 2021 SurgeonsPAC disbursements to congressional candidates and incumbents, find out more about SurgeonsPAC leadership, and better understand the role of political programs.

Note: Contributions to ACSPA-SurgeonsPAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of the ACSPA have the right to refuse to contribute without reprisal. Federal Law prohibits ACSPA-SurgeonsPAC from accepting contributions from foreign nationals. 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 name of the employer of individuals who contribute more than $200 in a calendar year. ACSPA-SurgeonsPAC is a program of the ACSPA, which is exempt from federal income tax under section 501(c)(6) of the IRS.