Advocacy Monthly: September 2019

September 2019

STS Contests Reimbursement Cuts in Proposed Fee Schedule
The Society has submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the calendar year 2020 Physician Fee Schedule proposed rule. The comment letter strongly opposed several proposals that would reduce reimbursements for cardiothoracic surgeons. Increases to reimbursement for evaluation and management visits could result in surgical payment cuts of up to 8%, which is separate from a CMS proposal to significantly reduce reimbursements for procedures, including pericardiotomies, aortic grafts, and pericardiocenteses. In addition, a CMS contractor has recommended additional cuts to cardiothoracic surgery reimbursement of up to 20%, based on significantly flawed data and analyses.

Thanks to the 68 STS members who recently reached out to their representatives, lawmakers will be sending a letter to CMS opposing these cuts—but the fight is not nearly over. The Society will share additional information on how members can help ensure that surgeons are reimbursed fairly for the care that they provide.

STS also signed a Physician Clinical Registry Coalition comment letter on the proposed rule. The coalition’s comments focused on updates related to Qualified Clinical Data Registries (QCDRs) and expressed concern that CMS may shift the costs of administering the Merit-Based Incentive Payment System onto specialty societies that create measures and operate QCDRs.

Efforts Move Forward to Ban Flavored E-Cigarettes 
As investigations into recent vaping-related deaths and illnesses continue, the Society is working with numerous public health groups on efforts to ban flavored e-cigarettes. STS has signed two Campaign for Tobacco-Free Kids letters praising the Administration’s plan to remove all flavored e-cigarettes, including mint and menthol flavors, from the market. The letters encouraged swift implementation of the proposal and rejection of tobacco industry pleas to weaken the plan’s effectiveness.

In addition, the Society signed a coalition letter asking senators to pass the Stopping Appealing Flavors in E-Cigarettes for Kids Act. The bill would ban flavorings in cigars altogether and restrict kid-friendly flavorings in e-cigarettes, unless an e-cigarette manufacturer could demonstrate that a flavor would help adults quit smoking cigarettes, does not encourage youth smoking, and does not increase the risk of harm to the user.

Society Requests Information on Heparin Shortage
STS sent a letter to the Food and Drug Administration (FDA) asking for details about how the agency is addressing the current heparin shortage. The Society requested that the FDA publish resources on how providers can access the anticoagulant during this shortage, as well as information on the agency’s strategy for monitoring the quality of the heparin supply. The shortage stems in part from an outbreak of swine fever in China, where the majority of heparin is produced. If you or your colleagues are experiencing a shortage of heparin, report it at or 240-402-8380. In addition, if you notice reduced efficacy or any adverse events in cases where heparin is used, contact the FDA via its MedWatch Voluntary Reporting page.

STS Comments on Publicizing Hospital Charges, Data Access
In a comment letter addressing several aspects of the Hospital Outpatient Prospective Payment System proposed rule, STS warned CMS to exercise caution in implementing a proposal to publish all hospital standard charges, including services provided by physicians. The letter noted that publicizing hospital-based providers’ salaries could lead to unfair negotiating practices between hospitals and providers. The Society also encouraged the agency to provide QCDRs (such as the STS National Database) with continuous access to Medicare claims data, as required by the Medicare Access and CHIP Reauthorization Act.

Society Pushes for Changes to Prior Authorization Process
The Society signed two coalition letters regarding modifications to rules for prior authorization. The first letter supported legislation that would help protect patients from unnecessary delays in care by streamlining and standardizing prior authorization under the Medicare Advantage program. The second letter suggested that CMS should take a broader approach to prior authorization reform, rather than solely focusing on automating approvals.

Key Contact Connect: Meet with Legislators during Recess
Today is the first day of a Congressional recess that lasts through October 14. That means your representatives are back in their districts, interacting with constituents. So now is the time for you to fight for the specialty’s interests as a grassroots advocate. If you’d like to schedule a meeting with your member of Congress, contact Madeleine Stirling for assistance.