ACS Advocacy Brief: April 6, 2023

Advocacy Summit Offers In-Person Meetings with Legislators to Advance Surgical Priorities

Already in 2023, the ACS has been advocating in the new Congress to address surgical workforce shortages, trauma funding, and more (see below for more information). At this month’s Leadership & Advocacy Summit, you can learn the skills to make advocacy inroads, and then make an impact by meeting leaders from Congress in-person on Capitol Hill. 

Register today for the  Leadership & Advocacy Summit, April 15–18, at the Grand Hyatt Washington, DC. 

The Summit offers comprehensive and specialized sessions focused on effective surgeon leadership, as well as interactive advocacy training with coordinated visits to Congressional offices.

Train for Advocacy and Meet Lawmakers

The Advocacy Summit will take place Sunday evening, April 16, to Tuesday, April 18, and provides US ACS members with an update on ACS policy priorities. 

Following a keynote address on Sunday evening with Jim VandeHei and Mike Allen, cofounders of Axios, Monday’s panel sessions will cover issues including physician payment; diversity, equity, and inclusion; healthcare quality; advocacy asks for the 118th Congress from healthcare groups outside the surgeon community, and more.

Advocacy training and scheduled congressional visits also will be provided as part of the event, with ACS members heading to the Hill equipped to ask Congress for updates on a range of issues, including, but not limited to:

• Stabilizing and Reforming Medicare physician payment
• Prior Authorization relief
• Funding for:
• Cancer research
• Firearm injury prevention research
• Rare surgery on a global scale
• ACS trauma policy priorities
• Commission on Cancer policy priorities

The Advocacy Summit will be an in-person event with some recorded sessions; there will be no virtual option.

Check Out the Leadership Summit

Preceding the Advocacy Summit, the Leadership Summit will take place Saturday evening, April 15, to Sunday, April 16, and will offer compelling speakers addressing key topics in surgical leadership. 

Both in-person and virtual attendance options are available. The Leadership Summit will be livestreamed, and the sessions also will be recorded for future viewing opportunities by both in-person and virtual registrants.   

Lawmakers Heighten Focus on Healthcare Workforce Challenges

The Senate Health, Education, Labor and Pensions Committee recently issued a Request for Information (RFI) on the root causes of the current healthcare workforce shortage and potential ways to address it, signaling Congress’s growing attention to this critical issue.

The ACS response urges Congress to improve data collection on surgical workforce shortage areas, enhance funding for graduate surgical education, provide loan repayment programs to surgeons who choose to practice in areas of need, and continue its focus on physician health, wellbeing, and administrative burden reduction.

One policy solution highlighted in the RFI response is the Ensuring Access to General Surgery Act, recently introduced by Representatives Larry Bucshon, MD (R-IN), Ami Bera, MD (D-CA), John Joyce, MD (R-PA), and Scott Peters (D-CA). The bill would direct the US Health Resources and Services Administration (HRSA) to study and define general surgery workforce shortage areas and grant the Secretary of Health and Human Services the authority to provide a general surgery shortage area designation.

General surgeons are uniquely trained and qualified to provide certain necessary, lifesaving procedures, making them an essential element of a community-based health system. However, unlike other key providers, general surgeons do not currently have a formal workforce shortage area designation. The Ensuring Access to General Surgery Act will allow HRSA to determine what constitutes a surgical shortage and designate areas where patients lack access to surgical services, providing a valuable new tool for increasing patient access to the full spectrum of high-quality healthcare, regardless of geographic location.

Trauma Coalition Letter Urges Funding for MISSION ZERO Grant Program

The ACS, along with partners in the Trauma Coalition, sent a letter urging leaders of the US House of Representatives Appropriations Committee to fully fund the Military and Civilian Partnership for the Trauma Readiness (MISSION ZERO) grant program at the authorized level of $11.5 million for fiscal year (FY) 2024.

The grant program was established in 2019 as part of the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019 to defray the associated costs for the civilian hospitals of embedding military surgeons into their systems. The grant allows military surgeons to gain skill and expertise treating critically injured patients in a civilian setting, increasing readiness for when these units are deployed.

Continued funding for the MISSION ZERO grant program will enhance trauma training for military healthcare personnel, especially as surgeons and other healthcare professionals continue to face challenges including ongoing staffing shortages, burnout and wellness concerns, and insufficient capacity. The ACS welcomes the $4 million Congress allocated for the program in FY 2023 and urges Congress to fully fund this critical program to improve the nation's response to public health and medical emergencies.

ACS Provides Written Testimony on Funding Priorities

Congress has begun its annual appropriations process to allocate specific funding amounts to federal agencies and programs for FY 2024. The ACS recently submitted written testimony to the US House Appropriations Subcommittee on Labor, Health, and Human Services as part of a multipronged approach to ensure that ACS priorities are funded for the year.

In addition to fully funding MISSION ZERO, the ACS encourages Congress to provide increased funding for cancer research and firearm injury prevention research at the Centers for Disease Control and Prevention and the National Institutes of Health, and fully fund the National Health Care Workforce Commission.

ACS Governor Recounts Efforts to Address Disparities in Obesity Surgery in Texas

At the Texas State ACS Chapter Advocacy Day, held February 23, I joined Linda Dultz, MD, FACS, Advocacy Chair of the North Texas ACS Chapter, and Robert Carpenter, MD, FACS, Advocacy Chair of the South Texas Chapter, to address the healthcare disparities in obesity surgery affecting the medical system in Texas. This is a critical issue, as 35.7% of Texans are obese. 

A 2020 Texas Department of Health and Human Services Report indicated obesity (BMI >30 kg/m²) affects 41.2% of Black Americans, 40.3% of the Latinx population, and 32.5% of White residents.

Socioeconomically, 40.4% of obese Texans have a household income of less than $35,000; 44.5% have less than a high school diploma; and 40.4% have no healthcare coverage. The impact on the workforce is staggering, as 77.2% of obese Texans are under the age of 65, with comorbidities and illnesses that limit their years of productivity.

Raising Awareness

To educate Texas state legislators about the respective ACS Chapters and the American Society of Metabolic and Bariatric Surgery, the ACS shared the ACS Bariatric Surgery Coverage Toolkit to help frame the salient issues surrounding our requests.

The College encouraged the Senate, House of Representatives, and the General Assembly to identify ways to augment coverage in coordination with insurance carriers—primarily Medicaid—to include bariatric surgery. The expansion of the Well Texas Program (Medicaid) to cover bariatric surgery also was discussed.

Discriminatory benefits regarding bariatric surgery currently exist in several states such as California, Michigan, New Mexico, New York; there are higher copays and deductibles, limits on types and numbers of surgeries based on expected outcomes, and discriminatory insurance policy clauses, including violations of the Affordable Care Act by establishing limits on care. The discussion emphasized that obesity surgery is an effective therapy, and there is a need to address the discrepancies in access to care to help all Texans. 

Getting Involved

Disparities in healthcare face every level of surgical practices, and ACS Fellows have an ethical responsibility to advocate for their patients and profession. Although taking time away from busy clinical practices can be difficult, spending time with legislators is necessary to address patient health. The ACS strongly encourages members to get involved in their ACS chapter and engage their respective legislators via lobby days and other advocacy efforts.

Learn about Revamped Hernia Coding, Changes to Medicare Billing

The in-person ACS/Karen Zupko & Associates (KZA) Current Procedural Terminology (CPT) coding course will be held August 3–4, in Nashville, TN.

With Medicare and third-party payer policy and coding changes taking effect in 2023—some with significant potential reductions in payment for surgeons—it is imperative that surgeons and their coding staff have accurate and up-to-date information to protect reimbursements while optimizing efficiency.

• August 3-4, 2023
  Loews Vanderbilt Hotel, 2100 West End Avenue, Nashville, TN
  Reservation Phone: 877-879-7818
  Register today!

The course includes sessions on hospital E/M and critical care coding, Thursday, August 3 at 1:00–5:00 pm, and general surgery coding, Friday, August 4 at 8:00 am–4:00 pm.

Session #1: Reporting Hospital E/M Codes and Split/Shared and Critical Care Services Course

Topics covered will include E/M codes for inpatient/facility, major changes in CPT code selection, and major changes to Medicare’s billing rules for both split/shared services and critical care.

Session #2: General Surgery: Revenue and RVU Optimization Course

Topics covered will include the revamped abdominal hernia codes (e.g., the use of the same CPT codes for both laparoscopic and open procedures, and basing codes on the total size of the hernia). In addition, this session will cover coding for endoscopy, colorectal, and breast, among other procedures.

ACS members and their staff receive a registration discount. For issues with registration, email KZA at education@karenzupko.com, or call 312-642-8310.

For more information or questions about the 2023 ACS live coding workshops, visit the KZA website, or send an e-mail to practicemanagement@facs.org.