1. Library of Congress. Public Law H.R. 2. Medicare
Access and CHIP Reauthorization Act. Available at:
5D%7D. Accessed May 14, 2015.
2. Fix Medicare now. Available at: fixmedicarenow.org/
action-kit.pdf. Accessed May 18, 2015.
3. Replacing the SGR: The latest developments in the
ACS Value-Based Update proposal. Bull Am Coll Surg.
2013; 6(98): 72. Available at: bulletin.facs.org/2013/06/
replacing-the-sgr/. Accessed May 14, 2015.
4. Hoyt DB. Looking forward. Bull Am Coll Surg.
2012; 8(97): 4-5. Available at: bulletin.facs.org/2012/08/
looking-forward-august-2012/. Accessed May 14, 2015.
5. Congressional Budget Office. Medicare’s Payment
to Physicians: The Budgetary Effects of Alternative
Policies Relative to CBO’s January 2015 Baseline.
Corrected February 3, 2015. Available at: https://www.
SGR_Options.pdf. Accessed May 18, 2015.
6. W&M SGR manager’s amendment to hike pay 0.5% in
response to surgeons. Inside Health Policy, December
7. H.R. 2—Medicare Access and CHIP Reauthorization
Act of 2015, §101—Repealing the sustainable growth
rate (SGR) and improving Medicare payment for
physicians’ services, subsection (a) Stabilizing fee
updates, sub-subsection ( 3) MedPac reports. Available
%5D%7D. Accessed May 18, 2015.
8. Kliff S. The problem with the new Medicare law, in one
chart. Available at: www.vox.com/2015/4/23/8482129/
medicare-sgr-value. Accessed May 14, 2015.
9. Hoyt DB. Looking forward. Bull Am Coll Surg.
2013; 7(98): 7-8. Available at: bulletin.facs.org/2013/07/
looking-forward-july-2013/. Accessed May 14, 2015.
Repealing the SGR was an important victory for the College and for all Medicare physicians; however, passage
of MACRA was only the first step. For the new quality-focused payment system to work, the College and other
physician organizations will need to be active partners in
the development of new quality measures, APMs, CPIAs,
and so on. The College will continue to work with CMS
and, if necessary, Congress to make the current quality
programs more practical for surgeons. It is important to
remember that these programs and the associated penalties remain in effect through the end of 2018 and will form
the core of MIPS.
The College will seek out all opportunities to share its
expertise and century of experience in quality improvement with policymakers as MIPS is developed and will
actively explore APMs to ensure that relevant models for
surgical practice are in place. ACS staff will provide additional guidance to Fellows to ensure that they are ready
to perform under the new system.
College scores a victory on global codes
In November 2014, CMS finalized a policy that would
have transitioned all 10- and 90-day global codes to 0-day
global codes. Independent analysis showed that this would
have resulted in a cut in reimbursement to surgeons for
most procedures. A coalition of surgical groups led by
the ACS advocated strongly for Congress to prevent CMS
from moving forward with its plan. The College’s efforts
were successful, and instead of eliminating 10- and 90-day
codes, CMS will instead collect data on the number and
level of visits furnished during the global period and use
these data to improve the accuracy of the valuation of
surgical services. The September issue of the Bulletin will
include an in-depth story on this issue. ♦
POST-SGR MEDICARE PHYSICIAN PAYMENT
A flow chart graphic on Medicare payment/quality programs is
available at www.facs.org/advocacy/quality/medicare-programs.