†American College of Surgeons. Statement on medical liability reform.
Bull Am Coll Surg. March 2015. Available at: bulletin.facs.org/2015/03/
statement-on-medical-liability-reform/. Accessed April 10, 2017.
Independent Payment Advisory Board
The ACS supports the repeal of the Independent
Payment Advisory Board. The ACS maintains that
Medicare payment policy should remain the primary purview of Congress rather than delegated
to an unelected, unaccountable governmental body
that may minimize input from stakeholders and citizens. Any binding mandates promulgated from such
a body that affect reimbursement should be fairly
constructed, spread across the spectrum of all health
care interests, and not directed at any one sector,
such as surgery.
Process for valuing codes under
the physician fee schedule
• The ACS opposes the creation of a duplicative process
for determining code values.
•The surgical community supports maintaining the
role of the American Medical Association/Specialty
Society Relative Value Scale Update Committee
(RUC) as the entity through which medical services
• The RUC continues to be a dynamic body, which makes
recommended increases and decreases in the value of
codes reimbursed under the Medicare physician fee
• The RUC has maintained budget neutrality.
• The ACS opposes reassignment of 10-day and 90-day
global codes to 0-day, where stakeholder specialties have
not requested a change in global codes.
• The ACS opposes use of a reverse building block meth-
odology to revalue codes, which would subtract work
values for changes in postoperative visits, unless clear
documentation is available to show that the code value
was created using the building block methodology.
• The ACS supports code valuation that uses magnitude
estimation to appropriately align codes relative to one
Medical liability reform
In accordance with the “Statement on medical liability reform” developed by the ACS Legislative
Committee and approved by the Board of Regents
in October 2014,† the ACS actively supports the
•Reforms based on safety, quality, and accountability
•Continued advocacy for traditional reforms where
appropriate and feasible
•Legislation that eases structural barriers to implementation of patient-centered reforms, specifically
with respect to National Practitioner Data Bank
reporting requirements and apology laws
•Culture change among hospitals and providers to
embrace swift adoption of alternative patient-centered
reforms, including communication and resolution
Meaningful medical liability reform would
reduce health care costs and improve patient access
to care, as demonstrated by the following examples:
•Before taking legislative action in 2008, Texas ranked
48th out of 50 states in terms of physician workforce,
averaging 152 physicians per 100,000 population in
contrast to the national average of 196.
•After passing strong medical liability reforms in 2008,
Texas received more than 4,000 physician licensure
applications compared with 2,500 received in 2002.
MAY 2017 BULLETIN American College of Surgeons
STATEMENT ON HEALTH CARE REFORM