Advocacy Monthly: November 2018

November 2018

STS Urges Reversal of ECMO Payment Reductions
The Society recently spearheaded a coalition letter requesting that the Centers for Medicare & Medicaid Services (CMS) reverse changes to extracorporeal membrane oxygenation (ECMO) Medicare Severity Diagnosis Related Group assignments that were finalized last month. The changes affect how peripheral veno-arterial and veno-venous cannulation for ECMO are classified and may reduce hospital reimbursement by up to 80% in 2019. Given that the cost and complexity of care for ECMO patients is unrelated to the method of cannulation, STS has asked CMS to mitigate the negative impact of these changes.

Provide Feedback on How Advocacy Issues Affect Your Practice
STS is conducting an important Member Needs-Assessment Survey to better understand your professional demands. In addition to guiding decisions on future educational content and member benefits, the survey results will help STS prioritize its efforts in Washington, DC. Share your thoughts on which advocacy issues are most important to you such as coding and reimbursement, Medicare payment reform, federally funded research, and more. If you haven’t already done so, please complete this online survey; it should take only about 7 minutes. Individual responses will remain anonymous and confidential, and only aggregate survey data will be shared with the membership.

Society Requests Changes to Payment Reporting
STS signed a letter providing feedback to CMS on reporting requirements for the Open Payments Program. The letter urges the agency to exempt journal reprints and medical textbooks from reporting by using a preexisting statutory exclusion for “educational materials that directly benefit patients.” The letter also asks CMS to work with stakeholders on a common set of definitions for what is reportable.

Documentation Requirements Eased for E/M Visits
CMS has finalized a rule that will make the documentation of evaluation and management (E/M) visits easier for surgeons. Starting next year, surgeons will only need to document what has changed since the last visit for established patients; it will no longer be necessary to re-record all required elements. Surgeons also can simply note that they have verified information entered into the medical record by other staff, instead of having to re-enter it themselves.

In addition, following significant concerns from the medical specialty community, CMS has delayed implementation of its proposal to change reimbursement for certain office/outpatient E/M code levels until 2021.

STS Highlights Difficulties with MIPS
The Society endorsed a Physician Clinical Registry Coalition letter to CMS and the Department of Health and Human Services regarding issues with the Merit-Based Incentive Payment System (MIPS). Qualified Clinical Data Registries such as the STS National Database have had difficulty verifying the tax identification numbers of eligible clinicians and determining whether clinicians meet data completeness. The letter also expresses concerns with the timeline for finalizing MIPS measures, as well as measure harmonization.

Key Contact Connect: Grassroots Advocates Host Baylor Site Visit
STS member Subhasis Chatterjee, MD, Director of the Thoracic Surgical ICU and ECMO Programs at the Texas Heart Institute at CHI Baylor St. Luke’s in Houston, and 4th-year medical student Alyssa Thomason recently hosted staff members for Rep. Ted Poe (R-TX) at their institution. Their discussion focused on the recent cuts to ECMO reimbursement, and Dr. Chatterjee requested that Rep. Poe take action in addressing these detrimental changes. STS Key Contacts play an important role in the Society’s advocacy efforts, and there’s still time this year to speak with your Congressional representatives regarding ECMO or other issues. Email Madeleine Stirling for assistance in setting up meetings or phone calls.

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

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