Advocacy Monthly: December 2019

December 2019

Funding Bill Reauthorizes PCORI, Raises Tobacco-Purchasing Age
In a big win for cardiothoracic surgeons and their patients, the fiscal year 2020 appropriations bill that recently was signed into law addressed two of the Society’s advocacy priorities. The legislation secured funding for the Patient-Centered Outcomes Research Institute (PCORI) until 2029. This means that PCORI can continue enabling important, patient-focused research on health care decision making. The appropriations package also included a provision raising the age for purchasing tobacco to 21, which will help protect kids and young adults from the harmful effects of smoking. Both PCORI reauthorization and tobacco control were primary discussion topics during meetings between surgeons and lawmakers at the STS Legislative Fly-In this summer.

STS Endorses Anti-Vaping Legislation
In further tobacco control efforts, the Society is supporting two bipartisan bills that would limit vaping:

  • The Smoke-Free School Act of 2019 would ban e-cigarettes and other electronic nicotine delivery systems (ENDS) in schools and child care facilities that receive federal funding. Traditional cigarettes currently are prohibited in such establishments; this bill would update existing laws to forbid “the use of any tobacco product.”
  • The Providing Resources to End the Vaping Epidemic Now for Teenagers (PREVENT) Act, sponsored by members of the Congressional Caucus to End the Youth Vaping Epidemic, would charge a user fee to manufacturers and importers of ENDS. The estimated $200 million generated by this fee would be used to develop anti-vaping programs for schools, a social media educational campaign, and resources to help treat youth nicotine addiction.

Annals Article Explains How Reimbursement Cuts Will Hurt the Specialty
Impending cuts to cardiothoracic surgery reimbursement represent a very real threat to the financial viability of cardiothoracic surgery practices and, more importantly, could limit patient access to care. A new report in The Annals of Thoracic Surgery outlines what’s at stake. “2020 Medicare Final Payment Rule: Implications For Cardiothoracic Surgery,” by Alan M. Speir, MD, and colleagues on behalf of two STS workforces, is available online now and will be published in the February 2020 issue of The Annals.

Society Urges CMS to Reconsider Measure Testing Requirement
STS signed a Physician Clinical Registry Coalition letter to the Centers for Medicare & Medicaid Services (CMS) expressing concerns about a new measure testing provision. The final rule for the 2020 Quality Payment Program stated that all quality measures developed by Qualified Clinical Data Registries—such as the STS National Database—must undergo testing before the measures can be submitted for inclusion in the Merit-Based Incentive Payment System. The letter argued that measure testing is prohibitively expensive, is not possible to complete in the timeframe provided by CMS, and would not generate any significant benefit, considering that the quality measures already undergo thorough expert vetting and are supported by literature, guidelines, and preliminary data.

STS Encourages Expanded Access to Cardiac Rehabilitation
The Society endorsed the Increasing Access to Quality Cardiac Rehabilitation Care Act of 2019. This legislation would move up the start date (to January 1, 2020, instead of 2024) allowing physician assistants, nurse practitioners, and clinical nurse specialists to supervise patients’ day-to-day care in cardiac and pulmonary rehabilitation programs. This change would be an important step in ensuring that more patients take advantage of these programs.

Key Contact Connect: Millikan Attends District Office Meeting
STS Key Contact J. Scott Millikan, MD, recently met with Rep. David Schweikert (R-AZ) to discuss telehealth, surprise billing, and tobacco control. “The Congressman seemed very knowledgeable and supportive,” Dr. Millikan said. “I think he is sympathetic to the problems facing physicians and our patients.” Your legislators need to hear from you on the issues that matter to the specialty. For help with scheduling a visit at your institution, district meeting, or phone call, contact STS Government Relations.