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Health Policy & Advocacy

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Cosmetic Tax Removed From Senate Health Reform Legislation

The “cosmetic tax,” a provision included in “The Patient Protection and Affordable Care Act of 2009” that would impose a 5% tax on cosmetic procedures, was removed from the Senate health reform legislation passed on December 24th, 2009. This removal is a major victory for plastic surgeons as the proposed provision would have had a significant negative impact on plastic surgeons and their patients.

ASPS will continue to work with the surgical coalition to improve any final health care legislation and ensure that a cosmetic tax provision is not included in the final bill.

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Dates for Regional Advocacy Fly-Ins and Joint Surgical Advocacy Conference (JSAC) Announced 

Your participation is vitally important in our upcoming ASPS sponsored Federal Advocacy Event in Washington, D.C.!  Please join us in your nation’s capitol to learn first hand about the critical issues facing our specialty and take that message directly to lawmakers on Capitol Hill.  This event affords you an opportunity to help shape the critical issues facing plastic surgeons and your patients.  We hope that you will join us to represent plastic surgery and your state. We need your participation!The fly-in dates are:

Midwest/West: April 13th and 14th

Northeast:  May 4th and 5th

Southeast:  September 21st and 22nd

Importantly, the third annual Joint Surgical Advocacy Conference (JSAC) will also be held in Washington D.C. July 25th – 27th.  In 2009, 19 surgical societies converged on Washington, DC to participate in JSAC and meet with lawmakers on the key issues most critical to surgery.  ASPS is on the planning committee for this event that brought over 400 surgeons to Washington last year. We hope you will join us for both JSAC and your regional advocacy event!

To RSVP for these events, please contact Pete Wallace at (202) 672-1519 or by email at pwallace@plasticsurgery.org.

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Urgent Information Regarding Billing for Consultation Services

On January 1, Medicare will no longer pay for the office/outpatient and inpatient consultation codes, CPT 99241-99245 and 99251-99255.

ASPS has issued a Special Bulletin to its members, explaining the new consultation billing guidelines. View the Special Bulletin

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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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ASPS Comments to CMS on the Final Physicians Fee Schedule (12/29/09)

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.

View the complete ASPS comment letter to CMS for "Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY2010; Final Rule; CMS-1413-FC".

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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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