ASPS Ramps Up Opposition to Medicare Payment Cuts

Since the August 3 introduction of a controversial proposed rule by CMS recommending cuts to 2021 Medicare E/M payments for plastic surgery by approximately 7%, ASPS has been escalating its opposition to the measure through a range of advocacy initiatives and legislative and regulatory activities.

This policy has now reached a critical juncture, where your voice is needed to help urge CMS and Congress to stop the proposed cuts. Join your colleagues nationwide in this effort by adding your signature to two separate letters – one to Capitol Hill and one to CMS – requesting key actions to ensure sufficient payment continues to physician practices.

A better solution

The proposed Medicare Physician Fee Schedule cuts will deal a devastating blow to both physicians and patients at a time when practitioners are facing increased financial strain due to the ongoing COVID-19 public health emergency. Rather than slash Medicare payments and risk adverse outcomes for patients and providers, ASPS has been urging Congress to:

• Waive the budget neutrality requirements for the Medicare PFS and implement positive payment updates for 2021 and 2022 that reflect the continually increasing costs of providing care to patients; and
• Direct CMS to apply the 2021 increases in values for office and outpatient E/M services to the E/M component of 10- and 90-day global codes, in order to value and price surgical care in a manner that follows precedent and maintains relativity among services paid under the Medicare PFS.

Applying pressure

ASPS has been active on this issue since day one – sounding the alarm on the adverse impacts of the E/M and conversion factor changes and serving as one of the founders of the Surgical Care Coalition. ASPS staff, leadership and various coalition partners continue to work diligently to stop the proposed cuts.

Recent advocacy efforts have taken a multi-track approach, focused on both CMS and Congress and urging the two to work together to waive budget neutrality requirements for the MPFS and implement positive payment updates for 2021 and 2022. The proposed rule was also one of the legislative priorities and a key talking point for ASPS physicians in virtual Hill meetings with members of Congress during the Northeast and Midwest Virtual Fly-In on September 16.

In those meetings, ASPS members re-iterated the Society's position and urged their congressional representatives to sign on to a bi-partisan letter to HHS and CMS requesting that the agencies engage with stakeholders in establishing fair and equitable payment solutions that address Medicare payment cuts, while at the same time moving forward with policies to increase payments to primary care and other office-based specialties. The letter calls on HHS and CMS to take immediate actions to delay or mitigate the proposed cuts, while allowing the scheduled increases to go into effect.

In conjunction with the Virtual Fly-In and leading into a dedicated Week of Action on the issue, ASPS launched the grassroots campaign asking members to sign on to the letters to Congress and CMS. During the Week of Action, ASPS also signed on to a joint letter from more than 20 organizations representing surgeons across the United States to all members of the US House urging Congress to pass legislation that increases the global codes and halts implementation of the new add-on code. Other coalition efforts included a letter to House and Senate leaders from the Alliance of Specialty Medicine, in which ASPS and other member organizations stressed the importance of acting "before the end of the year to prevent significant Medicare pay cuts."

Within Congress, physician champions have been actively engaged on the issue. Representatives Larry Bucshon, MD (R-IN) and Ami Bera, MD (D-CA) crafted and circulated a Dear Colleague letter asking fellow lawmakers to sign on and signal their support for Congressional action addressing the cuts before the end of 2020. ASPS and other key coalition partners worked closely with Representatives Bucshon and Bera to provide input and expertise in the development of the letter. Additionally, Rep. Michael Burgess, MD (R-TX) developed a legislative solution that would forestall the cuts for one year.

Week of Action

On September 21, ASPS was proud to join fellow members of the Surgical Care Coalition in launching a coordinated, week-long campaign in opposition to the cuts, dubbed the "Week of Action." The event included several public initiatives to highlight the need for Congress to stop the cuts, including: an education webinar; grassroots email and social media campaigns; a radio tour with surgeons from Netflix's Lenox Hill, Dr. Boockvar and Dr. Langer; and a public campaign to raise awareness of the issue nationally.

Your voice needed to stop harmful payment cuts

As a physician leader, your voice is needed to help stop the steep cuts proposed by CMS, and with the payment reductions scheduled to take effect on January 1, 2021, time is of the essence. Add your signature to letters to Congress and CMS today to protect physician practices and preserve Medicare beneficiaries' timely access to specialty care.