American Society of Plastic Surgeons
For Consumers

Coordinated Efforts Against Medicare Payment Cuts See Robust Participation, Bear Fruit

As covered in a September Advocacy Matters article, ASPS has been a dedicated partner in a widespread effort among specialty physician organizations to prevent proposed Medicare cuts including evaluation and management (E/M) payments from going into effect January 1. The advocacy against the cuts – likely to hit plastic surgery at approximately 7 percent – has focused on both CMS and Congress, urging the two to work together to waive budget neutrality requirements for the Medicare Physician Fee Schedule (MPFS) and implement positive payment updates.

The initial efforts were largely collaborative, with a mix of formal coalitions like the Surgical Care Coalition and ad hoc groups of like-minded organizations pushing hard through the media and congressional outreach to amplify the seriousness of the issue. As the issue progressed, though, individual organizations began to mount their own, dedicated efforts.

ASPS made the cuts one of the central issues discussed during meetings with congressional offices held at the Northeast/Midwest ASPS Regional Fly-In in September, asking Congress to stop the cuts and encouraging members to sign Dear Colleague letters circulating through the House that support a stop to the cuts. ASPS also developed a comprehensive organizational response to the rule that provided a point-by-point justification for the depth of plastic surgery's concerns. Perhaps most impactful, though, was the engagement of individual ASPS members.

ASPS launched a grassroots advocacy campaign that sought to bring concerned ASPS members together in one message with one, large voice. Two letters were developed. One was sent to CMS Administrator Seema Verma and requested that all available steps be taken to prevent the cuts. The second was sent to every member of Congress asking that they pass legislation that will allow CMS to legally forestall the cuts. The response to the campaign was substantial, with 243 ASPS members signing.

The attention to Congress has paid dividends within the House, as seen by three substantial developments. First, the Dear Colleague letters noted above received robust support within the House. One letter, spearheaded by Representatives Bobby Rush (D-IL) and Roger Marshall, MD (R-KS), called on HHS to "take immediate action to delay or mitigate the cuts" and drew 161 members of the House as signatories. The second letter, led by Representatives Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN), was sent to House leadership as means of demonstrating the volume of support for fixing this problem among the members of the House. It drew support from 229 members of Congress – roughly 53 percent of the House – from both sides of the aisle and across 47 states.

As support has been built in the House for action to address the cuts, and as more-and-more members of Congress have come to understand that some sort of legislative fix will be necessary, Drs. Bera and Buschon have been developing legislative solutions. In October, they released several possible short-term fixes in the form of draft legislation that ASPS and stakeholders in the physician community are currently reviewing and providing feedback on. Hope remains that Congress can develop a viable solution and get it passed following the election, during a lame-duck session of Congress.

Please keep your eye out for additional messages from ASPS seeking your help to advance these measures once they are formally introduced. Plastic surgery needs to continue to demonstrate broad and passionate support for this issue as it is evaluated and put to a vote so that no one in Congress can claim they didn't understand the impact of the cuts.