Beltway Briefings
October 2008
STS is pleased to present this issue of Beltway Briefings, an e-newsletter with the latest and most important regulatory and legislative news relevant to you as a cardiothoracic surgeon. We hope you find it of interest. If you have comments or suggestions, please e-mail npuckett@sts.org.
Loan Forgiveness Program Signed into Law
On Aug. 14, 2008, President Bush signed into law "The Higher Education Opportunity Act," (P.L. 110-315). The new law includes a provision (Sec. 430) advocated by STS that grants student loan forgiveness to borrowers employed full time in professional "areas of national need." Included are medical specialists who have been accepted or currently participate in a graduate medical education training program or fellowship that requires more than five years of graduate medical training and has fewer U.S. medical school graduate applicants than the total number of positions available in such program or fellowship. The provision is designed to encourage future physicians to select specialties with long training periods, such as cardiothoracic surgery. Borrowers who qualify for the program could have a maximum of $10,000 forgiven over no more than five years beginning in fiscal year 2009. Implementation of the loan forgiveness provisions must first undergo a process of negotiated rulemaking. No further information from the Department of Education was available at the time of this publication.
STS Responds to CMS Solicitation for Comment on Drug Eluting Stents
On Sept. 27, STS responded to the Centers for Medicare and Medicaid Service's solicitation for public comment on the off-label use of drug eluting coronary stents (DES) as a potential National Coverage Determination topic. In its letter, STS noted that there is a growing body of research indicating that DES is not a clinically appropriate intervention for coronary disease in certain patient populations. STS cited the initial results from the SYNTAX (Synergy between PCI with TAXUS drug-eluting stent and Cardiac Surgery) trial. The Society concluded that the use of DES in patients with complex coronary disease is a patient safety issue that warrants study of current Medicare payment policies for off-label use.
STS Submits Comments on Proposed Medicare Payment Policies
In August, STS submitted comments to the Centers for Medicare and Medicaid Services (CMS) on 2009 Part B proposed payment policies and revisions. STS's comments focused primarily on the expansion of the Physician Quality Reporting Initiative (PQRI), the inclusion of direct inputs for clinical staff in practice expense calculations, and the creation of a targeted exception to self-referral laws for incentive payment and shared savings programs between hospitals and physicians. Final publication of the 2009 Part B payment policies and physician fee schedule is expected for early November. To read the Society's comments go to http://www.regulations.gov/ and search for The Society of Thoracic Surgeons. The posting date for STS's comments was Aug. 30, 2008.
STS Weighs In on Medicare Physician Payment Reform
On Sept. 11, the House Ways and Means Health Subcommittee held a hearing on Medicare physician payment. In announcing the hearing, Subcommittee Chairman Pete Stark (D-CA) said that the purpose of the hearing is to "examine payment system reforms that encourage better care coordination, higher quality care, and more efficient use of resources." During the hearing Stark asked witnesses about ways to reduce variation of care and increase the value of primary care services. STS President W. Randolph Chitwood, Jr., MD, submitted a letter for the hearing record along with an editorial authored by STS Immediate Past President John E. Mayer, Jr., MD, and published in The Annals of Thoracic Surgery. A copy of the letter and editorial can be found on the committee Web site at:
http://waysandmeans.house.gov/hearings.asp?formmode=view&id=7428
Surgical Societies Gather to Discuss Medicare and Health System Reform
On Oct. 22, STS joined its surgical society colleagues in Washington, DC to map out a united health care reform agenda for surgery. Representing STS at the meeting were Keith S. Naunheim, MD, chair of the STS Council on Health Policy and Relationships, and John E. Mayer, Jr., MD, STS Immediate Past President. Given the competition for Medicare dollars and the interest by many in Congress to boost payments for primary care, it will be important for the surgical community to work together to emphasize the value surgeons bring to the health care system and to encourage surgical payment policies that are fair and that promote quality and accountability.
New STS Director of Government Relations
On Nov. 3, Phillip Bongiorno will join the STS staff as the new Director of Government Relations. Phil has specialized in association government relations for the past 15 years and has extensive experience in federal and state legislative lobbying, regulatory affairs policy development, and grassroots program administration. Most recently, he served as the Senior Director for Government Relations at the American Academy of Audiology in Washington and also held government relations positions with the American Public Health Association and the College of American Pathologists. A graduate of Indiana University of Pennsylvania, Phil will be based in the STS Washington, DC office and can be reached at pbongiorno@sts.org or (202) 481-1027.
Beltway Briefings is an e-publication for members of The Society of Thoracic Surgeons. Comments concerning content and advocacy initiatives may be referred to Phil Bongiorno, STS Director of Government Relations, at advocacy@sts.org. Please forward this issue to any colleagues, patients, and friends who are interested in the latest happenings in national health policy as it relates to cardiothoracic surgery. Copyright 2008.
