In recent weeks, the ACS has reached out to the new leaders of the US Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) to offer expertise on all things surgical. In addition, a proposed rule for inpatient payment was released.
ACS Requests Meeting with HHS, CMS Leadership
On April 17, the ACS submitted letters to Robert F. Kennedy Jr., Department of Health and Human Services (HHS) Secretary, and Mehmet Oz, MD, Centers for Medicare & Medicaid Services (CMS) Administrator. The letters acknowledged Secretary Kennedy’s and Administrator Oz’s recent confirmations and requested meetings to discuss opportunities for collaboration with HHS and CMS to optimize care for surgical patients.
The ACS encouraged HHS and CMS to improve price and cost transparency by working with ACS in developing episode-based tools that benefit patients and reduce provider burden. The College advocated for improvements to quality and value by prioritizing programmatic quality measures that align with episode-based cost measures, and the use of trusted data sources, such as the ACS National Surgical Quality Improvement Program.
To protect patient access to care, the ACS urged the Administration to reduce the number of uninsured Americans, prioritize rural surgical care, and eliminate barriers for coverage by limiting the scope of prior authorization.
In addition, the ACS highlighted the importance of stabilizing the Medicare physician payment system and appropriately valuing surgical services. The ACS also expressed its support for efforts that ensure the safety and effectiveness of innovations in digital health technology, such as artificial intelligence and medical devices.
The ACS further encouraged HHS to support life-saving surgical research by maintaining federal funding and improving the country’s response to public health emergencies by investing in a national trauma system.
For more information, contact regulatory@facs.org.
CMS Releases FY 2026 Inpatient Prospective Payment System Proposed Rule
On April 11, 2025, CMS released the fiscal year (FY) 2026 Inpatient Prospective Payment System (IPPS) proposed rule. This rule, published annually, proposes updates to payment rates for inpatient stays at acute care hospitals, as well as quality reporting requirements.
CMS proposes several changes to the Transforming Episode Accountability Model (TEAM), which the Agency first introduced in the FY 2025 IPPS rule. TEAM is a 5-year, episode-based payment model beginning January 1, 2026. TEAM focuses on lower extremity joint replacement, surgical hip and femur fracture treatment, spinal fusion, coronary artery bypass grafts, and major bowel procedures.
The model is mandatory for all hospitals in select geographic areas, but CMS proposes implementing a deferment period of up to 2 years for certain hospitals. The Agency proposes aligning the TEAM quality measures with other CMS quality programs, update its pricing and risk adjustment methodologies, and remove requirements related to health equity and social drivers of health.
CMS proposes several updates to quality measures across incentive programs, including the removal of several measures related to health equity. CMS also seeks input on advancing digital quality measurement in its quality programs.
The FY 2026 IPPS rule also proposes changes to Medicare Severity Diagnosis Related Groups (MS-DRGs) and OR versus non-OR designations for certain surgical procedures.
The ACS is evaluating these and other proposals to determine their impact on surgery. For more information, contact regulatory@facs.org.
