Washington Scene: STS Advocacy Secures Big Win; Fight Isn’t Over

STS News, Fall 2019 — The Society’s advocacy efforts regarding extracorporeal membrane oxygenation (ECMO) recently paid off in a major way, but challenges still lie ahead for physician reimbursement.

In August, the Centers for Medicare & Medicaid Services (CMS) confirmed that reimbursement for ECMO will be based on patient acuity and resource needs, rather than cannulation approach, for the fiscal year that began on October 1. This decision reverses detrimental changes to hospital coding and reimbursement for ECMO enacted last year and follows months of advocacy by STS, the Extracorporeal Life Support Organization, and a broad group of stakeholders. 

Coming off this important win, STS members face a new call to arms. In the proposed rule for the 2020 Physician Fee Schedule, CMS stated plans to cut reimbursement for cardiothoracic surgery by up to 8%. The agency has refused to modify the value of postoperative visits in the 10- and 90-day global surgical periods commensurate with updates to office/outpatient evaluation and management codes, improperly lowering the value of the global surgical period relative to other services in the Medicare Physician Fee Schedule, violating current law by creating specialty differentials, and ignoring recommendations from nearly all medical specialties. And that’s not all—CMS also is considering additional cuts to cardiothoracic surgery reimbursement of more than 20%.

STS has joined a coalition of surgical specialties criticizing the CMS proposal and also has submitted its own comments denouncing the proposed cuts. More help is urgently needed, however. It will take active engagement from all STS members to fend off these latest attacks on the specialty. Visit sts.org/keycontact to find out how you can connect with your Congressional representatives and urge them to take action on these important issues.

CMS is expected to release the final Fee Schedule this fall.

Ioannis M. Karamichalis, MD, Sen. Lamar Alexander (R-TN, 2017 STS Legislator of the Year), V. Seenu Reddy, MD, MBA, and Sen. Marsha Blackburn (R-TN) discussed pending legislation supported by the Society.

STS Members Push for Policy Changes on Capitol Hill

A key component of the Society’s grassroots advocacy strategy is its annual Legislative Fly-In. In July, 30 STS members met with more than 70 members of Congress in Washington, DC, to discuss residency slots, research funding, and tobacco control. Several senators and representatives agreed to cosponsor or vote for legislation supported by the Society, showing the impact that surgeon voices can have on the political process.

“Attending the Fly-In helped me see beyond my practice and my patients,” said cardiothoracic surgery resident Clauden Louis, MD, from the University of Rochester Medical Center in New York. “It gave me a more comprehensive view of how the health care system works and why our advocacy is so important.”

Social events, including a breakfast, happy hour, and celebratory thank you dinner, brought attendees together to network and share tips on navigating Capitol Hill.

“The camaraderie helped me feel more prepared and less anxious, and it was especially helpful to speak with others who had prior Fly-In experience,” said first-time attendee Dawn S. Hui, MD, from The University of Texas Health Science Center at San Antonio. 

Sen. Bill Cassidy, MD (R-LA, center), was presented with the STS Legislator of the Year Award.

Also during the Fly-In, the Society presented its Legislator of the Year Award to Sen. Bill Cassidy, MD (R-LA). Sen. Cassidy, a gastroenterologist who has served in the Senate since 2014, has championed STS advocacy priorities such as helping the STS National Database gain access to Medicare claims data and repealing the Sustainable Growth Rate. He also is working to protect patients from surprise medical bills by creating a fair process for settling discrepancies between providers and insurers.

The STS Legislator of the Year Award acknowledges a member of Congress who has made sustained and/or extraordinary efforts in promoting issues of importance to cardiothoracic surgeons and their patients through legislation, funding, or other outreach to policymakers.

Read more: Sen. Bill Cassidy, MD, shares his perspective on the most important issues in health care at sts.org/cassidy.

To see more photos and watch a behind-the-scenes video from the Fly-In, visit sts.org/fly-in.