Advocacy Monthly: April 2019

Advocacy Monthly

Cardiothoracic Surgery Wins Reversal of Damaging ECMO Policy
STS, along with the Extracorporeal Life Support Organization and a broad group of stakeholders, has worked tirelessly since last year to reverse a detrimental policy on extracorporeal membrane oxygenation (ECMO) imposed by the Centers for Medicare & Medicaid Services (CMS). After several letters and in-person meetings, the Society successfully persuaded CMS to reverse its policy that negatively affected ECMO coding and reimbursement, restricted ECMO program expansion, limited current programs, and put patients’ lives at risk. A final rule will be published this summer, and additional information about the application and implementation of the resulting changes will be shared with you as it becomes available.

STS Opposes Lower-Volume Requirements Proposed for TAVR
CMS is expected to publish its new national coverage determination for transcatheter aortic valve replacement (TAVR) by June 24. In advance of that release, STS joined the American Association for Thoracic Surgery, American College of Cardiology, and Society for Cardiovascular Angiography and Interventions in submitting comments opposing easier standards for initiating and maintaining a TAVR program. The societies expressed concerns that lowering TAVR volume requirements could result in worse patient outcomes and statistically invalid quality assessment.

Wood, Lahey to Serve on MEDCAC
CMS has invited two STS surgeon leaders to join its Medicare Evidence Development & Coverage Advisory Committee (MEDCAC). Past President Douglas E. Wood, MD, and Workforce on Health Policy, Reform, and Advocacy Chair Stephen Lahey, MD, begin service in June. MEDCAC was established to provide independent guidance and expert advice to CMS on specific clinical topics as a supplement to the agency’s internal expertise.

Don’t Miss the All-New Legislative Fly-In VIP Experience
The Society’s annual Legislative Fly-In is being revamped into a VIP experience designed to celebrate the STS members who take time out of their busy schedules to advocate for the specialty in Washington, DC. The date for the 2019 Legislative Fly-In has been changed to July 15-16. To secure your spot at this exclusive event, email Madeleine Stirling. Scholarships are available and will cover reasonable travel and meal expenses. Apply online by Thursday, May 30 to be considered; award decisions will be made in early June.

STS Takes Action to Preserve Research, Limit Tobacco Use, and Expand Medicare Coverage
The Society is working with national medical societies, public health groups, and research organizations on the following initiatives that would benefit cardiothoracic surgeons and their patients:

  • PCORI Reauthorization—The Patient-Centered Outcomes Research Institute (PCORI) is an organization that helps inform health care decision-making by producing and promoting high-integrity, evidence-based comparative effectiveness research. A coalition letter sent to Congress calls for federal funding of PCORI to be maintained for at least 10 years. PCORI reauthorization is one of the Society’s 2019 Advocacy Priorities.
  • Electronic Nicotine Delivery Systems—The Society submitted a letter to the US Food and Drug Administration (FDA) regarding its recent draft guidance on electronic nicotine delivery systems (ENDS). STS supports the FDA's efforts to increase restrictions on:
    • Flavored ENDS products that are sold in ways that pose a greater risk for minors
    • Products targeting minors using television, radio, and social media advertisements
    • Products that do not have a premarket application submitted to the FDA by 2021 
  • Medicare Coverage of Skilled Nursing—The Improving Access to Medicare Coverage Act of 2019 is a bill intended to clarify rules regarding Medicare coverage of stays at skilled nursing facilities (SNF). The Society sent lawmakers a letter supporting the effort to count so-called “observational stays” toward the 3 days of inpatient acute care required for beneficiaries to qualify for an SNF referral.

Questions? Want to get involved in advocacy?
Contact the STS Government Relations office via email or at 202-787-1230.

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