Last week, the Centers for Medicare & Medicaid Services (CMS) issued a final rule aimed at reforming the prior authorization (PA) process. The U.S. Department of Health and Human Services (HHS) estimates that these changes will result in approximately $15 billion in savings for physician practices over the next decade.
Join Representative Mariannette Miller-Meeks and members of the STS Council on Health Policy and Relationships for this 1-hour long exclusive webinar specially dedicated for STS-PAC contributors.
In observance of Lung Cancer Awareness Month, STS participated in a congressional press conference focused on the importance of lung cancer screening hosted on the U.S. Capitol grounds on Thursday, November 16. The event, hosted by Congresswoman Kathy Castor (D-FL), aimed to bring attention to the urgent need to get more people screened for lung cancer.
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Dr. Keith Mortman with Congresswoman Debbie Wasserman Schultz
STS joined other key stakeholders in the lung cancer community at this event, including LUNGevity Foundation, American Lung Association, GO2 for Lung Cancer, Moffitt Cancer Center, the Roswell Park Comprehensive Cancer Center, and Rep. Debbie Wasserman Schultz (D-FL).
STS has a long history of advocating for robust patient access to lung cancer prevention, screenings, and treatment. “Over the past decade, significant progress has been made to expand insurance coverage of lung cancer screening, yet this press conference highlighted that significant challenges remain to increasing screening rates among at-risk individuals,” said Keith Mortman, MD, who participated in the press conference and is a member of the STS Workforce on Health Policy, Reform, and Advocacy. “While innovative treatments for lung cancer are rapidly emerging, not everyone has equal access to these cutting-edge treatments. STS is relentlessly advocating with policymakers in Washington to remove barriers and increase access so our members can offer the highest quality lung cancer care possible.”
To advance this priority, STS has advocated for H.R. 4286, Increasing Access to Lung Cancer Screening Act, a bipartisan bill introduced by Reps. Brian Higgins (D-NY), Brian Fitzpatrick (R-PA), and Kathy Castor (D-FL), that would require all state Medicaid programs to cover lung cancer screenings for eligible enrollees as recommended by the U.S. Preventative Services Task Force (USPSTF). Urge your lawmakers to support this legislation today.
On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) published the Medicare Physician Fee Schedule final rule. Despite vocal opposition from The Society of Thoracic Surgeons (STS) and many others in the physician community, this rule finalizes a greater than 3% reduction to physician reimbursement beginning January 1, 2024.
When adjusted for inflation, Medicare physician payments have declined by 26% since 2001. This latest reduction is the most recent example of a trend that is unsustainable and impacts patient access to care. These cuts are due to the implementation of the flawed complexity add-on code G2211, combined with expiring temporary relief previously enacted by Congress. The final rule also contains a few positive developments. CMS agreed with STS’s concerns that raising the required threshold to avoid a penalty in the Merit-based Incentive Payment System (MIPS) from 75 to 82 points was inappropriate at this time because the MIPS program has been largely paused since 2019 due the COVID-19 pandemic. CMS also approved several new intraoperative cardiac ultrasound CPT codes (76987–76989) at higher levels than in the proposed rule, which will be available to cardiothoracic surgeons next year.
Fortunately, the Senate Finance Committee recently released a draft legislative proposal that seeks to extend relief payments for physicians that are slated to expire this year. If enacted, this would help counteract a portion of the cuts slated for 2023. STS will continue to urge Congress to halt this unsustainable cut and to enact policies such as H.R. 2474, the Strengthening Medicare for Patients and Providers Act, which would provide an annual automatic inflation update for physician payments going forward. Help us maintain adequate Medicare reimbursements by contacting your lawmakers now!
Learn more about STS’s advocacy efforts focused on the 2024 Medicare Physician Fee Schedule.
The Society of Thoracic Surgeons presented the Legislator of the Year Award to Congressman Raul Ruiz, MD, (D-CA), during a ceremony at the 2023 STS Advocacy Conference on October 17 in Washington, DC. The congressman was honored for his leadership on numerous policies impacting cardiothoracic surgeons and the physician community at large.
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Congressman Raul Ruiz, MD
“As an emergency physician, Rep. Ruiz understands the issues facing physicians and their patients. He works tirelessly on behalf of the community to address these issues head-on,” said Thomas E. MacGillivray, MD, STS President. “He has championed improvements to stabilize Medicare physician payments through an annual inflationary update. He also has played a key role in reducing physician burnout and maintaining an appropriate balance of power during insurance negotiations over billing disputes. STS is incredibly proud to be represented in Congress by a physician leader like Dr. Ruiz.”
