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Health Policy & Advocacy

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FDA Issues Warning on Negative Pressure Wound Therapy

The FDA warns physicians about the serious complications associated with negative pressure wound therapy.
FDA Warning

2010 Health Policy Scholarship Available  

The American Society of Plastic Surgeons and the American College of Surgeons are pleased to announce a shared scholarship open to members in good standing of both organizations.  This scholarship supports attendance and participation in the “Executive Leadership Program in Health Policy and Management,” which will take place June 13-19, 2010 at Brandeis University, Waltham, Massachusetts.  The award is in the amount of $8,000, to be used toward the cost of tuition, travel, housing, and subsistence.  Check out these additional details about the scholarship.

The deadline for receipt of all application materials is February 1, 2010.  Applicants will be notified of the outcome of the selection committee’s decision by March 31, 2010.

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House Leaders Unveil Reform to Medicare Physicians Payments

In conjunction with H.R. 3962, House leaders introduced a bill that would permanently reform the Medicare physician payment system. The Medicare Physician Payment Reform Act, H.R. 3961, stops the 21 percent fee reduction scheduled for January 2010 and replaces the current physician payment formula with a more stable system.

Under H.R. 3961, the SGR would be replaced with a new formula that:

  • Eliminates all SGR debt accumulated after years of temporary, unfunded fixes;

  • Removes items such as drugs and laboratory services not paid directly to practitioners from spending targets;

  • Allows the volume of most services to grow at the rate of GDP plus 1 percentage point per year (compared to GDP without any adjustment today);

  • Allows the volume of E&M services to grow at GDP plus 2 per year

We expect this bill to be brought before the House soon and urge you to contact your Representatives through the hotline number below. While similar legislation recently failed in the Senate, it is possible the Senate will review this legislation again if it passes the House.

Urge Your Representatives to VOTE YES on the Medicare Physician Payment Reform Act of 2009 (H.R. 3961)

The Medicare Physician Payment Reform Act of 2009 stops the 21 percent Medicare physician payment cut of January 1, 2010, and replaces the flawed sustainable growth rate (SGR) with a new payment formula.

Please call your Representative and urge a YES vote on H.R. 3961. Time is of the essence, so please call your Representatives by dialing 1-800-833-6354.

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CMS Released the CY 2010 Medicare Physician Payment Final Rule on 10/30/09

On October 30, 2009 the Centers for Medicare & Medicaid Services (CMS) announced final changes to policies and payment rates for services to be furnished during calendar year (CY 2010) under the Medicare Physician Fee Schedule. In the absence of Congressional action for the CY 2010 physician update, the conversion factor for services performed on or after January 1, 2010 will be cut by an unprecedented 21.2 percent. ASPS continues to work with organized medicine and Congress to eliminate the flawed sustainable growth rate and replace it with a more stable payment system to avoid these cuts in the future.

It is estimated that $122 billion will be restored to physician services over 10 years, through the retroactive removal of physician-administered drugs from the calculation of the physician fee schedule update. While this decision will not affect payments for services during CY 2010, CMS projects it will have a positive effect on future payment updates.

CMS is finalizing its proposal to include data about physicians’ practice expenses (PE) from the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association and 72 specialty societies including the ASPS. CMS has decided to phase in the new PE RVUs over a four year period.

Despite strong objection from ASPS, on January 1, 2010, CMS will no longer pay for consultation services other than the G codes that are used to bill telehealth consultations. In order to maintain budget neutrality, the work RVUs for new and established office visits, initial hospital and initial nursing facility visits will be increased. In addition, CMS has agreed to adjust the payment for surgical global procedures (10 and 90 days) to reflect the higher value of the office visits furnished during the global period.

The Physician Quality Reporting Initiative is back with a two percent incentive payment for CY 2010, and the final rule includes the addition of a six-month reporting period beginning July 1, 2010, for claims-based reporting of individual measures. Additionally, CMS is finalizing its proposal to allow eligible professionals to choose to report data through claims, qualified registry, and new for CY 2010, qualified Electronic Health Records.

The ASPS Coding and Payment Policy Committee worked with CMS to revise the global period for CPT Code 19340 (Immediate insertion of breast prosthesis following mastopexy, mastectomy or in reconstruction). In CY 2010, the global period will change from ZZZ to 90 days. In the past, there has never been a + denotation preceding code 19340 in the CPT manual to identify it as an add-on code, which has caused confusion and denials from Medicare and other payers. It is our hope that this change will alleviate the problems surrounding the code.

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New Evidence-Based Advisories Announced

The ASPS Patient Safety Committee is pleased to announce the publication of the Evidence-Based Patient Safety Advisory for Ambulatory Surgery. This supplement, which serves to update previous advisories and introduce new topics, is a collection of evidence-based articles aimed at evaluating and managing the ambulatory and office-based surgical patient. The supplement is published as part of the October 2009 issue of Plastic and Reconstructive Surgery. Together, the following patient safety advisories provide a comprehensive manual for delivering high quality care and improving outcomes in ambulatory surgery.

We thank the authors and ASPS for their efforts in creating this first class supplement, and hope you'll find it of great value in your clinical practice of plastic surgery.

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FTC's Red Flags Rule Deadline Extended Yet Again to June 1, 2010

At the request of members of the United States Congress, the Federal Trade Commission (FTC) is delaying enforcement of the "Red Flags" Rule again until June 1, 2010, for financial institutions and creditors subject to enforcement by the FTC. The delay gives creditors and financial institutions more time to develop and implement written identity theft prevention programs. This is only a delay, and the FTC still deems physicians as "creditors" and therefore all providers will still be subject to the rule on June 1, 2010. Health care practices must establish a compliance program that complies with the regulations. ASPS, along with the AMA and other physician specialty organizations, continue to contend that physicians should not be subject to these rules and are not "creditors" in this regard.

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