Editor’s note: To help readers stay up-to-date on the activities of the American College of Surgeons advocacy and health policy activities, the Bulletin is introducing a new column to the online version of the publication—“Dateline DC.” The inaugural column follows.
2018 MPFS Schedule Final Rule Released Without Comment Period
The Centers for Medicare & Medicaid Services (CMS) issued the 2018 Medicare Physician Fee Schedule (MPFS) final rule November 2. The MPFS establishes a conversion factor of $35.99 and a projected 0.0 percent update for general surgery in 2018. Historically the MPFS—generally released the last week of October or first week of November—has been referred to as the final rule but was actually the interim final rule with a comment period. In rare circumstances, such as this year, the rule is final with no comment period.
According to the final rule, CMS received many public comments following release of the proposed rule in July regarding the revision of evaluation and management (E/M) guidelines. The agency has indicated that its efforts now are focused on updating the E/M guidelines to reduce unnecessary administrative burdens. CMS also finalized the valuation for a number of individual services, including those related to muscle flaps, strapping multi-layer compression, endovascular repair of abdominal aorta and/or iliac arteries, treatment of incompetent veins, tracheostomy, and esophagectomy procedures, to reflect the broad-based, multispecialty recommendations made by the American Medical Association/Specialty Society Relative Value Scale Update Committee.
In addition, the rule finalized several changes to policies for the 2018 Physician Value-Based Modifier to better align incentives and provide a smoother transition to the new Merit-based Incentive Payment System under the Quality Payment Program. Specifically, CMS reduced the automatic downward payment adjustment for not meeting the criteria to avoid the Physician Quality Reporting System (PQRS) adjustment from 4 percent to 2 percent for groups of 10 or more providers and from 2 percent to 1 percent for solo practitioners and groups of two to nine providers. In addition, CMS finalized a change to the current PQRS program policy that requires reporting of nine measures across three National Quality Strategy domains to only require reporting of six measures for PQRS with no domain requirement.
The American College of Surgeons continues to evaluate these and other proposals to determine the impact on general surgery. The final rule is available for public review, along with a fact sheet on its payment and quality provisions. Contact regulatory@facs.org with any questions.
ACS Hosts Bleeding Control Training to Raise Awareness on Capitol Hill
Leaders of the American College of Surgeons (ACS) hosted a Stop the Bleed® training program on Capitol Hill in October for members of Congress and their staffs. The congressional event focused on how early intervention from a Stop the Bleed-trained individual can save the life of someone suffering from a bleeding injury. In addition to providing valuable training to lawmakers, this event showcased the vital role that surgeons play in educating the public.
Participants came to learn more about the ACS’ efforts with Stop the Bleed and engage in the hands-on training in how to control bleeding. The training was led by ACS Fellows, including Lenworth M. Jacobs, Jr., MD, MPH, FACS; Leonard J. Weireter, Jr., MD, FACS; Mark L. Gestring, MD, FACS; John H. Armstrong, MD, FACS; Joseph V. Sakran, MD, MPH, MPA, FACS; and Jack Sava, MD, FACS. Congressional special guests included Reps. Ami Bera, MD (D-CA); Phil Roe, MD (R-TN); Raul Ruiz, MD (D-CA); and Brad Wenstrup, DPM (R-OH), who provided opening remarks.
Members of Congress and their staff left the program with a better understanding of how to become lifesaving immediate responders and the value of Stop the Bleed training. In addition to promoting Stop the Bleed training, the College is advocating for widespread access to bleeding control education before federal and state lawmakers.
For more information about ACS trauma advocacy, contact Justin Rosen, Congressional Lobbyist, at jrosen@facs.org or 202-672-1528. For more information about the Stop the Bleed program, visit BleedingControl.org.
ACS Continues Call for Passage of Good Samaritan Bill
The American College of Surgeons (ACS) sent a letter in October to the U.S. House Committee on Energy and Commerce Oversight and Investigations Subcommittee urging members to pass the Good Samaritan Health Professionals Act of 2017 (H.R. 1876). The bill would extend liability protections to health care professionals while they are serving as volunteers in response to a federally declared disaster, such as a hurricane or earthquake.
Hurricane Katrina highlighted the importance of trained volunteer health care professionals. During that disaster, more than 33,000 volunteer health professionals responded to the call for assistance through various emergency response programs. Unfortunately, many health care volunteers were delayed or turned away due to inconsistent state and federal volunteer liability protection laws, as well as confusion about the application of these laws. The ACS explained to lawmakers that H.R. 1876 would enable the rapid deployment of necessary health care resources during federally declared disasters.
The ACS continues its push for passage of H.R. 1876, which awaits action by the committee. Should it pass, it will go to the full House for consideration. Fellows are encouraged to contact their representatives and senators through SurgeonsVoice to ask for their vote. For more information, contact Justin Rosen, ACS Congressional Lobbyist, at jrosen@facs.org.
Dr. Opelka Provides Lawmakers with Insights to APM Approval Process
Frank G. Opelka, MD, FACS, Medical Director, Quality and Health Policy, American College of Surgeons (ACS) Division of Advocacy and Health Policy, testified November 8 before the U.S. House Committee on Energy and Commerce Health Subcommittee. The subcommittee conducted the hearing—MACRA (Medicare Access and CHIP [Children’s Health Insurance Program] Reauthorization Act) and Alternative Payment Models: Developing Options for Value-based Care—to explore how Medicare payment reforms are shaping the way physicians provide treatment to patients.
Dr. Opelka described how the Advanced Alternative Payment Model (A-APM) developed by the ACS and Brandeis University, Waltham, MA—the ACS-Brandeis A-APM—proceeded through the Payment Model Technical Advisory Committee (PTAC) review and approval process. He shared how the ACS-Brandeis A-APM can revolutionize physician payment, as well as encourage and incentivize a team-based approach to patient care. Dr. Opelka expressed the College’s ongoing willingness to work with Congress on ways to improve and enhance patient care and Medicare physician payment.
A replay of the hearing is available on the Energy and Commerce Committee website, and a summary of Dr. Opelka’s testimony can be found on the ACS website. Watch Dr. Opelka’s testimony. For more information, contact Matt Coffron, ACS Manager of Policy Development, at mcoffron@facs.org.
