NewsScope: June 7, 2019
The U.S. House of Representatives June 4 passed S. 1279, The Pandemic and All-Hazards Preparedness and Advancing Innovation (PAHPAI) Act of 2019. This legislation was first created to improve the nation’s response to public health and medical emergencies and called for appointing an Assistant Secretary of Preparedness and Response (ASPR) to oversee the nation’s preparedness for disaster response. The ASPR’s responsibilities would include implementation of the recommendations from the June 2016 National Academy of Sciences, Engineering and Medicine report, A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury.
Included in this reauthorization is the American College of Surgeons (ACS)-supported Mission Zero Act. Mission Zero builds upon the legislative framework passed in the fiscal year 2017 National Defense Authorization Act by further incorporating military trauma care providers into the civilian setting. These military-civilian trauma care partnerships will increase military health care readiness and ensure the provision of high-quality trauma care both domestically and abroad.
The ACS applauds the work of the Senate and House to get this bill passed and to the President’s desk for signature. “PAHPAI represents significant progress in the process of ensuring that trauma systems, centers, and health care providers are able to meet the needs of all Americans,” said ACS Executive Director David B. Hoyt, MD, FACS. “This legislation establishes the framework for a trauma system that can provide the highest-quality emergency medical care.”
Read the ACS press release. For more information, contact Hannah Chargin, ACS Congressional Lobbyist, at [email protected].
ACS Responds to Draft Legislation to Lower Health Care Costs
The American College of Surgeons (ACS) submitted a response June 5 to the Senate Committee on Health, Education, Labor and Pensions on its bipartisan draft legislation, the Lower Health Care Costs Act. The goal of the legislation is “to deliver better health care outcomes and better health care experiences at lower costs.” The ACS commented on a number of provisions in the bill, including a heightened focus on increased transparency and steps to improve the exchange and availability of health data. The ACS also expressed its support of a comprehensive approach to maternal health care.
However, the ACS expressed strong concerns regarding legislative language that seeks to address surprise billing. The draft bill provides three options for stakeholders to choose from: force physicians to be in-network for all of the plans in which the hospitals they practice are in-network; an arbitration process that has a benchmark payment tied to the median in-network rate—a concept that the ACS is already on record as opposing; and a straight payment benchmarked to the median in-network rate. The ACS will continue to emphasize the potential consequences of resolving the issue of surprise billing with these troubling solutions.
Read the ACS response. For further information, please contact Kristin McDonald, Manager of Legislative and Political Affairs, at [email protected].
ACS Supports Legislation to Address Prior Authorization in Medicare Advantage
Reps. Suzan Delbene (D-WA), Mike Kelly (R-PA), Roger Marshall, MD (R-KS), and Ami Bera MD (D-CA), introduced legislation this week, The Improving Seniors’ Timely Access to Care Act, H.R. 3107, which would protect patients from unreasonable Medicare Advantage (MA) plan prior authorization requirements. MA plans originally required physicians to obtain prior authorization as a means of controlling costs by reducing medically unnecessary tests and procedures. However, health plans now widely use prior authorization indiscriminately, creating hurdles and hassles for patients and their physicians, which can lead to delays or denials of necessary care.
The Improving Seniors’ Timely Access to Care Act would bring greater transparency to the prior authorization process by requiring MA plans to report to the Centers for Medicare & Medicaid Services (CMS) on the extent of their use of prior authorization and the rate of approvals or denials by service and/or prescription medication. More than 100 members of Congress called for such reform in an ACS-supported bipartisan letter to CMS last year.
For further information, contact Carrie Zlatos, Senior Congressional Lobbyist, at [email protected].
ACS SSR MIPS 2019 Participation and Resources Now Available
Several MIPS 2019 educational and instructional resources, including quick guides and video demonstrations, also are now available on ACS SSR website, and you can sign up for one of several Q&A webinars the SSR program is hosting to provide guidance on MIPS 2019 participation.
The SSR is supporting the Quality and IA components of MIPS 2019, and submitting MIPS data through the SSR is considered individual, registry-based reporting by CMS. MIPS 2019 Quality Measures reporting includes options for general surgeons and plastic surgeons in addition to a wide range of other surgical specialties. For MIPS 2019 IAs, surgeons have 88 surgically relevant activities from which to choose for attestation, including two new opioid-related IAs.
The deadline to submit your MIPS 2019 data through the SSR is January 31, 2020.
For any SSR programmatic questions, including MIPS participation, contact the ACS SSR Program at [email protected] or at 312-202-5408. For SSR technical questions or issues (password reset, account reactivation, and so on), contact Technical Support at [email protected] or at 877-600-7237 (toll-free).
Join ACS and HBS Leaders July 19 for Unveiling of New THRIVE Initiative
Fellows of the American College of Surgeons (ACS) are well aware of the challenges that stand in the way of expanding access to care and providing innovative treatments to surgical patients—quality, cost, and interoperability. The ACS and the Institute for Strategy and Competitiveness at Harvard Business School (HBS) have collaborated to develop a path forward and will host an exclusive event July 19 in Washington, DC, to introduce THRIVE: Transforming Health care Results by Investing in Value and Excellence. The session will take place 9:30−11:00 am Eastern time at the Walter E. Washington Convention Center prior to the ACS Quality and Safety Conference.
Speakers at the event will describe the ACS and HBS THRIVE approach and specific plans for introducing a workable plan to shape the nation’s health care system into the model all health care professionals want and their patients deserve—one that emphasizes value over volume.
Leaders of the session are as follows:
- David B. Hoyt, MD, FACS, ACS Executive Director
- Robert S. Kaplan, senior fellow and Marvin Bower Professor of Leadership Development, emeritus, HBS
- Clifford Y. Ko, MD, MS, MSHS, FACS, Director, ACS Division of Research and Optimal Patient Care
- Frank G. Opelka, MD, FACS, Medical Director, ACS Quality and Health Policy
- Mary L. Witkowski, MD, MBA, fellow, Institute for Strategy and Competitiveness, HBS
Registration and networking opportunities begin at 8:30 am. To reserve your seat for this important preconference program, e-mail [email protected].
SurgeonsPAC Co-Chairs 12th Annual Medical and Dental PAC Forum
