Advocacy

This afternoon, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2026 Medicare Physician Fee Schedule Proposed Rule. STS has compiled a summary of the rule’s key provisions affecting cardiothoracic surgery.  

Physician Payment

Starting in calendar year (CY) 2026, the Centers for Medicare & Medicaid Services (CMS) will introduce two distinct conversion factors under the Medicare Access and CHIP Reauthorization Act (MACRA). Clinicians participating in Advanced Alternative Payment Models (APMs) will receive a conversion factor of $33.59, which reflects a 3.83 percent increase. Meanwhile, all other fee-for-service clinicians under the Merit-based Incentive Payment System (MIPS) will have a conversion factor of $33.42, representing a 3.32 percent increase. This new structure of two conversion factors replaces the previous lump-sum bonuses for physicians participating in APMs. Additionally, this is the first time in several years that CMS has proposed a positive adjustment to the conversion factor.

It is important to note that reimbursement still lags behind inflation.

Quality Payment Program (QPP)

CMS is moving forward with the requirement for mandatory subgroup reporting for all multispecialty groups participating in a MIPS Value Pathway (MVP) during the 2026 performance year, which affects payment for CY 2028. Currently, cardiothoracic surgery measures are included in the Surgical Care MVP. This group of measures is designed for surgical specialists to report separately from traditional MIPS. STS has submitted detailed recommendations to CMS to improve the Surgical Care MVP.

Deregulation Request for Information (RFI)

CMS is seeking feedback on ways to streamline regulations and reduce administrative burdens on providers and other stakeholders participating in the Medicare program. STS has previously responded to similar RFIs, offering recommendations to use existing clinical data registries instead of extraneous quality programs like MIPS, to reconsider global surgical package poster-operative data reporting, and to rescind the Appropriate Use Criteria program.

STS submitted a response to the proposed Centers for Medicaid & Medicare Services (CMS) hospital inpatient rule.  

Key highlights included:  

• Recommendations for improving the Transforming Episode Accountability Model, which will impact all coronary artery bypass grafting procedures at select hospitals starting in January 2026. 
• Suggestions for programs like the Merit-Based Incentive Payment System, global surgical post-operative data reporting, and the appropriate use criteria program for deregulation.
• Examples of ways CMS can enhance data quality through standardized collection of unique device identifiers and improved imaging interoperability. Additionally, we continue to advocate for access to federal claims data to support long-term clinical outcomes research.  

Read the full letter.  

Senate Intensifies Negotiations on the Reconciliation Bill

The Senate needs to hear from surgeons about reconciliation! Make your voice heard now.

• There are key concerns regarding the legislation, including substantial cuts to Medicaid, which could leave millions of people uninsured.
• The proposed increases to Medicare physician payments are modest despite ongoing financial pressures.

Legislation includes significant changes to federal student loan programs that could reduce access to affordable financing for medical education.  

Fifty-five STS advocates gathered in Washington, DC, on March 4 to engage with lawmakers on important policy issues, including protecting Medicare reimbursement and NIH research funding, and expanding access to lung cancer screenings. Participants from 23 states and the District of Columbia met with more than 110 Senate and House offices, while also participating in various off-the-Hill events and meetings with lawmakers.

The timing of this event was especially critical, as Washington, DC, is currently engaged in negotiations over government funding. Our advocates took this opportunity to present the priorities for the STS, its members, patients, and the communities they serve. Throughout the day, advocates worked to educate lawmakers and their staff, urging them to address the ongoing threats to research funding and physician reimbursement.

Leadership Efforts Drive Key Healthcare Legislation and Recognition

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Dr. Tessa London-Bounds, STS 2025 Advocate of the Year, along with Amanda Crabtree, RN, shared their experiences as advocates, highlighting their work to improve access to care for Kentucky patients. Their advocacy efforts led to the unanimous passing of House Bill 31 by the Kentucky legislature, which allows Medicaid patients to use at-home blood testing machines. Gov. Andy Beshear signed the bill into law on April 4, 2024, just four months after its introduction.

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Dr. Keith Naunheim, presented Rep. Mariannette Miller-Meeks (R-IA) with the 2025 STS Legislator of the Year award. As a longtime ally for STS, Rep. Miller-Meeks has championed efforts to address cuts to Medicare physician reimbursements. She also played a key role in promoting the Accelerating Kids’ Access to Care Act through the House of Representatives. Additionally, her leadership was instrumental in spearheading a bipartisan "Dear Colleague" letter last year that garnered 232 signatures in support of physician reimbursements.