SGO Issues June 11, 2015
Health Policy and Socioeconomic Committee working for you
SGO attempts to regain RVUs for Lap Hys and Lymphadenectomy
15 quality measures to be submitted to PQRS
SGO seeks volunteers to influence legislative and regulatory issues
SGR repeal, new conversion factor to be implemented July 1
SGO members mourn Michael Milam, MD, 1973-2015
By Laurel Rice, MD
Chair, SGO Health Policy and Socioeconomic Committee
This year SGO’s Government Relations Committee was reorganized into the Health Policy and Socioeconomic Committee. The change reflects a more robust approach to advocacy regarding policies that affect our members and the subspecialty of gynecologic oncology. The new committee is comprised of several mission-specific taskforces: Coding and Reimbursement; Future of Physician Payment Reform; Lobbying/Legislative and Regulatory Affairs; Quality, Outcomes and Policy and the SGO Registry. Seeing all of the work that has already been accomplished, it is clear to me that the Chairs, Co-Chairs, and members of these taskforces are serious honey badgers! I urge all of you to join them in their efforts to advocate for what is best for our patients, especially today, as the U.S. Senate will be debating this morning whether or not to retain funding for the Ovarian Cancer Research Program at the Department of Defense.
This edition of SGO Issues contains important updates on health policy matters that are important to our subspecialty and what our taskforce members are doing to address them. These include Relative Value Units for certain procedures, the submission of quality measures to the Physician Quality Reporting System, the importance of ambassadors to influence legislative and regulatory issues, and keeping members abreast of the new Medicare conversion factor replacing the Sustainable Growth Rate.
Of vital interest to our membership and the patients we treat is the U.S. Senate’s vote on the National Defense Authorization Act for Fiscal Year 2016 (HR 1735). Sen. John McCain (R-AZ) has filed an amendment to be offered during consideration of the bill that would effectively wipe out most of the Department of Defense’s Congressionally Directed Medical Research Programs (CDMRPs), including all cancer research programs. This amendment would eliminate the Ovarian Cancer Research Program at the Department of Defense.
Please take the time to read the articles in this week’s SGO Issues to learn more about what the Society is doing to advocate for our members and patients. We are especially appealing to all of our U.S. members to call their senators today and ask them to vote “no” on the McCain amendment, #1482.
SGO is conducting a survey of its gynecologic oncologist Full and Candidate members regarding the number of post-operative visits for laparoscopic hysterectomy (CPT code 58571) and lymphadenectomy (CPT code 38571). SGO’s Coding and Reimbursement Taskforce, led by Barbara A. Goff, MD, and Mark S. Shahin, MD, is working to obtain data to combat the recent reduction in Relative Value Units (RVUs) for laparoscopic hysterectomy procedures and the possible reduction for lymphadenectomy procedures in 2016 as determined by the Centers for Medicare and Medicaid Services (CMS).
It is our hope that the data collected from SGO members over the next two weeks will more accurately reflect the need for increased RVUs for these procedures. SGO has provided comments on the CY 2015 Final Medicare Physician Fee Schedule Rule opposing the interim values and has asked for refinement prior to their finalization in the CY 2016 Medicare Physician Fee Schedule.
Dr. Goff will present the data collected in this survey as well as data obtained from NSQIP and Coding Taskforce members’ practices to CMS later this summer. An email link to the survey was sent to all gynecologic oncologist Full and Candidate members in the United States on Wednesday, June 10. Please contact Debbie Leopold if you did not receive the survey link.
SGO’s Policy, Quality and Outcomes Taskforce, led by Matthew Powell, MD, and Sean Dowdy, MD, will submit 15 quality indicators for ovarian, endometrial and cervical cancers by the June 15 deadline to be considered by the Physician Quality Reporting System (PQRS) for inclusion on the 2015 Measures Under Consideration list for implementation in PQRS as early as 2017. Should these measures be accepted by the PQRS, SGO members can quantify how often they are meeting these particular quality metrics through SGO’s Clinical Outcomes Registry.
This is important as it provides a mechanism by which the Centers for Medicare and Medicaid Services (CMS) may make decisions to support new payment models where physicians may eventually be compensated for providing improved quality care rather than volume of services.
The SGO Legislative and Regulatory Task Force, led by Patrick F. Timmins, MD, and Heidi J. Gray, MD, is still recruiting SGO members to act as Congressional Ambassadors to contact Representatives and Senators in their respective states regarding issues pertinent to SGO members and their patients, including Department of Defense (DoD) funding for ovarian cancer research. These ambassadors have been instrumental in convincing some Senators to reconsider their stance on amendment #1482 to the National Defense Authorization Act for Fiscal Year 2016 (HR 1735), which would eliminate the Ovarian Cancer Research Program at the Department of Defense.
Last week the House Appropriations Committee released a report that included $20 million for ovarian cancer research funding as a line item (on page 273) in the DoD budget for FY 2016, but amendment #1482 threatens to remove this funding, effectively ending an important cancer research program that SGO members and their patients have relied upon since 1997.
As ambassadors for women’s health, SGO’s volunteer members must continue to contact the House members and Senators on the Appropriations Committees throughout the month of June to encourage them to maintain the level of funding that ovarian cancer research has received in the past. Additional outreach might be needed in the fall.
The SGO ambassadors will also play a role in issues related to Medicare physician payment, clinical trials research funding, and other health care policy issues in the future. Congressional Ambassadors are encouraged to meet with Members of Congress in their state or district or host a tour. SGO members who are interested in becoming an SGO Congressional Ambassador should contact Jill Rathbun, Director of Government Relations.
After Congress repealed the Medicare Sustainable Growth Rate (SGR) formula in April, a new system is being implemented to calculate the Medicare Physician Fee Schedule. Per the new law, a half percent update to the monies available for Medicare to pay physicians is scheduled for implementation on July 1. The Centers for Medicare & Medicaid Services (CMS) has published the new conversion factor of $35.9335, which is a slight increase over the current conversion factor. The American Medical Association provides further information about how H.R. 2 will impact physicians.
SGO’s Taskforce on the Future of Physician Payment Reform, led by Emily Ko, MD, and Ronald D. Alvarez, MD, has been working hard to implement the recommendations from SGO White Paper: Creating a New Paradigm in Gynecologic Cancer Care: Policy Proposals for Delivery, Quality and Reimbursement, published in the February 2013.
SGO regrets to announce the passing of Michael Robert Milam, MD, of Saint Thomas Gynecologic Oncology Specialists in Nashville, TN, who died at the age of 41 in the company of friends and family on June 3, one month after being diagnosed with stage IV gastric cancer.
“Michael completed an internship in obstetrics and gynecology at Washington University in St. Louis, a residency in obstetrics and gynecology at Vanderbilt University, and a fellowship in gynecologic oncology at the University of Texas MD Anderson Cancer Center,” according to the official obituary on Legacy.com. “Michael served as assistant professor of gynecologic oncology at the University of Louisville from 2009 to 2012 and practiced at the Norton Cancer Institute in Louisville, KY from 2012 to 2014. In 2014, he moved to Nashville, TN, to establish Saint Thomas Gynecologic Oncology Specialists and to serve as a clinical and research mentor to resident physicians from Vanderbilt University and the University of Tennessee.”
SGO president Robert L. Coleman, MD, said Dr. Milam will be remembered for the many roles that he played in his life.
“There are many superlatives to ascribe to Mike’s many roles that would be appropriate; father, husband, friend, colleague, mentor, community leader– I would strongly agree with them all,” said Dr. Coleman. “He will also be remembered as a physician…a healer. He embraced this role, enjoining the many unique characteristics of his humanity to enable the journey of others with disease easier. We dearly miss him.”
Dr. Milam is survived by his wife of 14 years, Ashley Milam; and children, Jack (9) and Ben (6) of Nashville; parents, Dr. Robert and Carolyn Milam of Hopkinsville, KY; brother, Charles Milam of Hopkinsville, KY, and extended family in Kentucky.
In a video interview posted by St. Thomas Health in October 2014, Dr. Milam explained his initial connection to St. Thomas that brought him back to the Nashville area, the importance of spending time with his wife, young sons and their extended family, and his philosophy towards treating his patients.
“I want to create a practice here where people come in, and they feel like they’re treated like family,” he said. “I want them to come in, and even though it’s a difficult time to be told you have cancer, or have a situation that could be cancer, to know that the people in the office and everyone in the office that works here has the same kind of philosophy. That we’re going to treat you well and you’re going to leave feeling better than when you came in.”
In lieu of flowers, expressions of sympathy may take the form of donations to the Foundation for Women’s Cancer or to Alive Hospice of Nashville.