As you may know from recent ACS communications, finalized policies from the Centers for Medicare and Medicaid Services (CMS) will result in significant cuts to physician payment for most surgical services delivered to Medicare patients beginning in January of 2021. If implemented, these policies could also destabilize health system financing and drastically diminish the opportunity for hospital and physician offices to recover financially from COVID-19. For more information, visit https://www.facs.org/advocacy/federal/medicare/prevent-cuts.

The ACS and other surgical associations have urged Congress to intervene and introduce legislation that would waive budget neutrality, effectively preventing the cuts. The ACS will also continue to aggressively push Congress, but only strength in numbers from surgeon advocates at-large will help elected officials understand the importance and time sensitivity of this issue.

Recognizing the profound impact that cuts to physician payment could have on practices and Medicare patients seeking surgical services, please take immediate action and contact Congress via SurgeonsVoice! For more information, contact the ACS Division of Advocacy and Health Policy staff at ahp@facs.org.

As health care facilities resume operations paused due to COVID-19, a new survey shows a majority of people are reluctant to undergo procedures and may not reschedule necessary care while COVID-19 continues to circulate in communities. To help surgeons and hospitals address patient concerns, the American College of Surgeons (ACS) has released a new resource:

Preparing to Have Surgery during the Time of COVID-19.

Surgeon Toolkit
(Download the Word version)

• Introduction
• Template Press Release
• Template Social Media Copy
• Template Social Media Images
• Template Video Script
• Template Article
• Additional Considerations

Surgeon-Patient Discussion Guide 

Surgeon-Patient Discussion Worksheet 

 

This award is offered through the generosity of The Clowes Fund, Inc., of Indianapolis, IN. Its purpose is to provide support for the research of a promising young surgical investigator. The award consists of a stipend of $45,000 for each of five years and is not renewable thereafter.

The award is restricted to a Fellow or Associate Fellow of the College who has completed an accredited residency in general surgery within the preceding seven years, not including time off for maternity leave, military deployment, or medical leave, and has received a full-time faculty appointment at a medical school accredited by the Liaison Committee on Medical Education in the United States or by the Committee for Accreditation of Canadian Medical Schools in Canada. The applicant’s academic appointment may not be above the level of assistant professor. Applicants should provide evidence (by publication or otherwise) of productive initial efforts in laboratory research.

For addition information about the award, please visit the George H. A. Clowes, Jr., MD, FACS, Memorial Research Career Development Award webpage.

The Centers for Medicare & Medicaid Services (CMS) recently released the 2020 Quality Payment Program (QPP) Exception Applications Fact Sheet. The fact sheet explains how to apply two types of exceptions: the Promoting Interoperability (PI) Hardship Exception and the Extreme and Uncontrollable Circumstances Exception. If individual clinicians, groups, and virtual groups meet certain criteria for a PI exception or experience extreme and uncontrollable circumstances—such as a natural disaster or public health emergency (including the COVID-19 pandemic)—they can submit an application to reweight their Merit-based Incentive Payment System (MIPS) Quality, Cost, Improvement Activities, and/or PI performance categories.

The fact sheet also explains situations where the automatic extreme and uncontrollable circumstance policy would be applied to individual clinicians located in a CMS-designated area affected by an extreme and uncontrollable event during 2020. However, CMS has not yet announced the COVID-19 pandemic as a triggering event for the automatic extreme and uncontrollable circumstances policy for the 2020 MIPS performance year. Therefore, if your 2020 MIPS data collection and reporting has been disrupted by the COVID-19 pandemic, you should submit application(s) for the extreme and uncontrollable circumstances policies.

To learn more, view the 2020 MIPS Exceptions Applications Fact Sheet here. Additional questions can be directed to QualityDC@facs.org.

2020 Claude H. Organ, Jr., MD, FACS, Traveling Fellowship
Deadline: June 30

The Organ Traveling Fellowship is awarded to an outstanding young surgeon so he or she can attend an educational meeting or make an extended visit to an institution of his or her choice, tailored to his or her research interests. The successful applicant will receive the sum of $5,000 U.S. This amount is to be used to help defray travel and per diem expenses, plus the cost of any courses the awardee may take in association with the award. Full details and requirements are HERE.

 

Gerald B. Healy, MD, FACS, Traveling Mentorship Fellowship
Deadline: June 30

The Gerald B. Healy, MD, FACS, Traveling Mentorship Fellowship will be used to facilitate visiting and engaging with one or more successful mentors. The successful applicant will receive the sum of $5,000 U.S. This amount is to be used to help defray travel and per diem expenses, and to subsidize lost revenue from days away from clinical duties. Full details and requirements are HERE.

June 16^th issue of the newsletter, Bulletin Brief, is available below.

Key highlights:

• Surgery Ramp-Up after COVID-19: Insight from ACS Board of Regents Vice-Chair Dr. L. Scott Levin
• ACS Supports Bill that Expands Liability Protection for Frontline Providers
• General Surgery Training Stakeholders Gather for Virtual Meeting
  RAS-ACS Sponsors Hangouts for Young Surgeons
• Use ACS Resources to Weather Negative Symptoms Caused by COVID-19

Today, the New York State Department of Health issued updated guidance for Resumption of Non-Essential Elective Surgeries and Non-Urgent Procedures in Hospitals, Ambulatory Surgery Centers, Office Based Surgery Practices and Diagnostic and Treatment Centers. Highlights from the guidance are included below and a link to the complete document is provided.

Hospitals

Hospitals in all counties may resume non-essential elective surgeries and non-urgent procedures in both inpatient and outpatient settings. Waivers are no longer required.

Hospitals should continue to monitor metrics, however, original thresholds of ICU total bed capacity, ICU bed capacity, and COVID hospitalization rate based on the HERDS survey data will no longer be used to qualify hospitals to resume and continue to perform non-essential elective surgeries and non-urgent procedures.

There is no longer a requirement to submit information about the types and numbers of surgeries and procedures to the Department on a monthly basis however, hospitals should have a mechanism to report this information to the Department if requested in the future.

Testing

The test period may now be extended from three days to five days prior to the surgery or procedure. Test results should be received and reviewed before conducting the surgery or procedure. The only exception would be a nonscheduled  emergent procedure where testing prior to surgery may not be feasible. In this case, a thorough screening and history should be taken as well as appropriate  precautions. A test should be performed as soon as possible, and if positive, may result in the need for health care worker exposure protocols to be followed. Providers / Hospitals do not have to perform the test; it is allowable to accept a third-party test provided it is a viral molecular assay as described above and is performed by a laboratory with any required permits and approvals.

Transfers / Hospital Capacity

The intention was clarified for for ambulatory facilities to maintain ongoing confirmation of local hospital capacity (bed census, ICU census, and ventilator availability). The intention of this guidance is for ASC, OBS, and DTC providers to monitor capacity at the hospitals to which they would normally be transferring to and/or recommend patients visit post procedure, if necessary. Providers should establish their own policies for frequency of monitoring and may monitor local hospital capacity by region at the following link: https://forward.ny.gov/early-warning-monitoring-dashboard.

PPE

There has been no change to the requirement for ASCs, OBSs and DTCs to have adequate PPE and medical and surgical supplies appropriate to the number and type of procedures to be performed. Adequate PPE means that an ambulatory provider has at least a seven-day supply of PPE on hand, and the provider’s supply chain can maintain that level to support outpatient surgeries and procedures without resorting to contingency or crisis capacity strategies. To prepare for a potential future surge, providers should be working towards having immediate access to a 90-day supply of PPE.

The June 9^th issue of the newsletter, Bulletin Brief, is available. Key highlights below:

• American College of Surgeons Issues Call to Action on Racism as a Public Health Crisis

• The ACS Board of Regents Held Its June Meeting Virtually Last Week—Mention of Clinical Congress is below

Planning for Clinical Congress 2020 to be presented remotely and consideration of a smaller live meeting in Chicago, IL, is under way. Issues to be addressed, based on the results of a member survey, include surgeons’ willingness to attend, the ability to realistically maintain social distancing with large crowds, and the impact of travel restraints some institutions have imposed. The concerns about a second surge in COVID-19 cases and the subsequent effect on the surgical workforce are real and are under consideration. A final decision will be made over the next two weeks.

• Annual Dues Will Not Increase Next Year

New Legislation Provides Greater Flexibility for Small Business Loans

As hospitals resume operations paused due to COVID-19, a new survey shows a majority of people are reluctant to undergo procedures and may not reschedule necessary surgical care while COVID-19 continues to circulate in communities.* To help surgeons and hospitals address patient concerns, the American College of Surgeons (ACS) has released a new resource, Preparing to Have Surgery during the Time of COVID-19.  

A new toolkit from the ACS accompanies the release of a patient discussion guide to help you communicate with your patients about the steps your hospitals are taking to reduce the risk of COVID-19, and stresses that, when it comes to talking about COVID-19, surgeon-patient communication is a shared responsibility. 

The survey also found surgeons are the most influential voices for patients wondering whether their care will be safe. Personalized outreach, including phone calls, can ease fears and allow patients to ask you questions about what they can expect when they arrive at the hospital, ambulatory center, or your office. They want to hear directly from you, and no level of detail is too much in our current environment. 

Included in this toolkit are templates and resources to help you reach out to patients directly who may also have wanted to reach out to you but are not comfortable making that first phone call. Also included are resources for traditional and social media, and your hospital or practice website, including:

• The aforementioned discussion guide, with sample questions that your patients may ask. This guide will help you gather the information you will need to have detailed conversations and answer potential patient questions.
• A companion document to help you prepare answers to anticipated patient questions and enlist members of the care team and administration as part of the preparation process. 
• A template press release that you can distribute to your local media.
• Sample social media posts, images, and tips for posting.
• A sample video script that can be used for recording on your phone or tablet, which you can post on social media or on your hospital or practice website. You can also work with your hospital’s media relations officer to record a video if your facility has its own studio or videographer. 
• A draft newsletter article that you can post on your hospital or practice website.
  

The June 2 issue of the newsletter, Bulletin Brief, is available below.

Highlights include:

• American College of Surgeons Condemns Recent Violence
• Don’t Miss It: ACS Practice Protection Committee Hosts Webinar on Economic Survival Strategies
• College News and Announcements
• Many Patients Fear Returning to Surgery in COVID-19 Era. New ACS Patient & Surgeon Resources Can Guide Communication to Help Restore Confidence