American Society of Plastic Surgeons
For Consumers

White House: Protect Seniors Quality of Care

In October, President Trump signed the Executive Order (EO) on Protecting and Improving Medicare for Our Nation's Seniors to strengthen the nation's Medicare program. While the Society appreciates the intent of the EO to increase patient choice and access to care, there were problematic provisions in the proposal that would undermine patient safety and the quality of specialty care received by for our nation's most vulnerable patient population.

One of the Society's leading concerns with the EO is Section 5, which would reduce the supervision of non-physician professionals and attempt to reimburse them at the same rate as participating physicians. Specifically, it would allow nurse practitioners (NPs) and physician assistants (PAs) to independently practice based on the misguided notion that this will help increase Medicare beneficiaries' access to care in underserved areas. The Society submitted comments in strong opposition to Section 5 of the EO to the Department of Health and Human Services (HHS) explaining that NPs and PAs do not have the requite medical education and training to independently practice. Giving them this authority and reimbursing them accordingly would undermine the physician-led team model that ensures quality patient outcomes.

Additionally, the Society joined more than 100 physician-led organizations in signing on to a letter by the American Medical Association (AMA) that articulated those same concerns and implored the agency to review the overwhelming research that proves that giving non-physicians independent practice actually increases the cost of care and undermines patient safety.

The Society also had concerns with how the EO addressed specialty care and overall physician reimbursement. ASPS joined the Alliance of Specialty Medicine – a coalition of specialty medical societies of which ASPS is a member – encouraging the Administration to improve the proposal by strengthening network adequacy requirements, streamlining MIPS and reducing administrative burden to ensure meaningful participation by specialty providers. Additionally, the Alliance articulated its strong concerns with the proposal's line items that further reduce Medicare fee-for-service rates based on reimbursements made to Medicare Advantage participating providers. ASPS believes that physician reimbursement rates should not be decreased, but rather increased to keep pace with medical inflation and to incentivize continued physician participation in the Medicare program.

ASPS will continue to work with these two coalitions as the U.S. Department of Health & Human Services begins implementing these policies. ASPS will advocate to ensure that the Medicare program continues to encourage specialty care participation and values the delivery of quality health outcomes for our nation's seniors.