Bulletin Advocacy Brief: April 21

Approximately 350 people attended this month’s ACS Advocacy Summit, both virtually and in Washington, DC, before participating in more than 150 virtual visits with Congressional lawmakers and their senior staff.

2022 ACS Leadership & Advocacy Summit attendees had the opportunity to meet virtually with members of Congress and staff to foster new and existing relationships and promote important ACS advocacy priorities. A total of 161 participants from 35 states, spanning 99 House districts and 70 Senate constituencies, met with key congressional decision-makers. More than 30% of meetings included senior advisors (such as chief of staff, legislative director) or members of Congress, demonstrating that legislators are eager to hear from ACS members.

Several surgeons and ACS leaders provided feedback on their experiences.

“The virtual visit with Rep. Susan Wild’s team provided an opportunity to discuss myriad issues and challenges facing surgery with a new congressional leader who has chosen to become increasingly informed and active in the complex healthcare needs facing surgical patients and the profession. The efforts made via the ACS staff to educate and support both legislators and constituents cannot be overstated!”

Shannon M. Foster, MD, FACS

Communications Pillar Lead, ACS Board of Governors

Reading, PA

“As always, Sen. Jerry Moran’s office was very receptive to our asks and highlighted his existing working relationship with CMS, including his interest in reviewing proposals regarding MACRA implementation. He is also very supportive of efforts to improve prior authorization and is in queue to cosponsor ACS-supported legislation.”

Denise Lantz

Executive Director, ACS Kansas Chapter

Topeka, KS

“We had a very productive meeting with Rep. Kathy Castor’s health legislative aid to discuss several areas of concern to ACS Fellows related to prior authorization, stabilizing the Medicare payment system, and recognizing the contributions of CoC and COT to American public health. The Summit provided a great opportunity to build a relationship with my representative’s staff, and I look forward to following up with both her DC and Tampa teams on these and other initiatives.”

John E. Mullinax, MD, FACS

Tampa, FL

“Meeting with Sen. Sherrod Brown’s office is always a pleasure. He has incredibly knowledgeable health policy staff who are receptive to ACS feedback and are continually seeking ways to improve healthcare in America for both patients and physicians. We had a great discussion about the importance of quality in reimbursement and how we can further explore alternative payment models.”

Alisha D. Reiss, MD, FACS

Secretary, ACS Ohio Chapter

Columbus, Ohio

“Participating in the Leadership & Advocacy Summit helps ensure I am using my voice as a surgeon to make a bigger impact. By meeting with legislative staff such as in Sen. Debbie Stabenow’s office, I can lend my voice and share stories to hopefully further shape healthcare policy. Making and maintaining connections with lawmakers and serving as a resource is essential to inform leaders about critical decisions that could impact healthcare delivery.”

Amalia J. Stefanou, MD, FACS, FASCRS

Chair, Governing Council, ACS Young Fellows Association

Detroit, MI

“Rep. Greg Murphy, MD, FACS, not only joined our meeting personally, but ensured three legislative aides joined the call to hear about ACS priorities. He asked great questions, provided overviews of what areas were likely actionable this year, and truly listened for opportunities to support practicing surgeons. As a urologist, he was particularly well-versed regarding issues surrounding surprise medical billing, including the need to prevent insurance conglomerates from inappropriately forcing surgeons into untenable contracts.”

Danielle Saunders Walsh, MD, FACS, FAAP

Chair, ACS Board of Governors

Greenville, NC

State Affairs

Take Action in Your State’s Political Battle for Epidermis

While some individuals will be prioritizing their sun tans this summer, others have been visiting indoor tanning facilities throughout the year. Among young women, use of indoor tanning facilities remains high despite associated risks such as skin cancer, premature skin aging, and weakened immune systems.

Despite the US Food and Drug Administration’s recommendation against the use of tanning beds by minors, nearly one-third of indoor tanners begin the practice before age 18. The ACS Commission on Cancer (CoC) is working with states to pass legislation that requires tanning bed users to be at least 18 years old, without an option for parental exemption. To date, 20 states and the District of Columbia have passed indoor tanning age requirements, including:

• California
• Colorado
• Delaware
• hawaii
• Illinois
• Kansas
• louisiana
• Maine
• Maryland
• Massachusetts
• Minnesota
• Nevada
• New Hampshire
• North Carolina
• Oregon
• Rhode Island
• Texas
• Vermont
• Virginia
• Washington

Women who are so indoors before the age of 30 are six times more likely to be diagnosed with melanoma, the deadliest form of skin cancer. In addition, research has shown that parents are encouraging indoor tanning use by either introducing the habit or signing exemption waivers for their children to tan in states that already have existing age requirements. Daughters who tan for the first time with their mothers are four times more likely to become heavy tanners in the future. Only three states have introduced bills regarding indoor tanning age requirements, including New York, Ohio, and South Carolina.

View the full list of cancer bills that the ACS is tracking.

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued the FY 2023 Medicare Inpatient Prospective Payment System (IPPS) proposed rule. Under the provisions of this rule, CMS projects a 3.2% increase in payment rates for inpatient hospitals paid under the IPPS in October 1, 2022−September 30, 2023.

CMS is not proposing any new Medicare Severity Diagnosis Related Groups (MS-DRGs) for FY 2023, which means the number of MS-DRGs would remain at 767. The agency is considering a request to reclassify laser interstitial thermal therapy (LITT) procedures under the MS-DRGs in connection with a proposal to create new ICD-10 procedure codes to describe LITT. CMS also continues to review ICD-10 diagnosis codes and the ICD-10 procedure code list, including when a procedure should affect MS-DRG assignment.

The agency proposes updates to the inpatient quality programs and highlights their efforts to advance health equity and maternal health through the incorporation of new measures and requests for information (RFIs). Consistent with the Executive Order on Advancing Racial Equity and Support for Underserved Communities through the Federal Government, CMS is seeking stakeholder feedback on ways to advance health equity across its quality programs, including efforts to improve data collection to better measure and analyze disparities. In an effort to reduce maternal mortality and morbidity and address disparities, the Hospital IQR Program proposes establishment of a publicly reported hospital designation that will report a structural measure on the quality and safety of maternity care.

Other key proposals include adding new measures and updates to the Hospital Inpatient Quality Reporting (IQR) Program, Promoting Interoperability (PI) Program, Hospital Readmission Reduction Program (HRRP), Value-based Purchasing (VBP) Program, and Hospital Acquired Condition (HAC). ) Program. Because of the impact of COVID-19 on measure data, CMS also seeks to suppress several measures in the Hospital VBP and HAC Reduction Programs.

In addition, the agency is proposing implementation of a special scoring methodology that will result in a value-based payment incentive that matches the DRG reduction amount. In other words, hospitals will not receive a penalty because of these programs. CMS also continues to ask for stakeholder feedback on advancements needed to transition to digital quality measurement.