This Week – April 29, 2017

This Week in Washington, D.C.

  • ACA Repeal Watch: Republican leadership still trying to secure votes in House
  • Important Date for ACG Members: May 15th for Sunshine Payment Review
  • At the State and Local Level: Update on ACG Activities on State MOC Legislation
  • Biosimilars subject of Supreme Court Discussion
  • MACRA Tidbit for the Week: CMS Notifications Forthcoming

From ACG National Affairs Committee Chair, Whitfield L. Knapple, MD, FACG

ACA Repeal Watch: Republican leadership still trying to secure votes in House

On Thursday, House Republican leaders delayed a vote on their revised Patient Protection and Affordable Care (ACA) repeal bill to take place next week at the earliest.  White House officials, after striking a deal with conservatives, had publicly raised expectations that the vote would occur this week.  The White House then privately pushed House Speaker Paul Ryan (R-Wis.) to vote on the measure at hand.  President Trump had hoped for a major legislative victory before Saturday, his 100th day in office.  However, House Republicans are still struggling to secure the votes within their caucus.

In other news, both the House and Senate overwhelmingly passed a bill on Friday to fund the government for one week, to avert a government shutdown at midnight (4/29). Congress is expected to pass a broader spending package next week to fund the government through September 2017.

A negotiated amendment brought health reform back into the spotlight this week.  The changes were negotiated by Freedom Caucus chairman Mark Meadows (R-NC) and Tom MacArthur (R-NJ), co-chair of the moderate Tuesday Group. Under the agreed proposal, states would be permitted to waive some of the ACA’s minimum coverage requirements and consumer protections, so long as they certified that they could offer an alternative that reduces premiums, enhances competition, or increases the number of people with coverage.  When the House tried to pass the American Health Care Act (AHCA) last month, it was the conservative Freedom Caucus that opposed the bill.  This time, however, it appears the moderate Tuesday Group members are causing trouble for Speaker Ryan and the White House.  Reports also surfaced that Rep. MacArthur negotiated the amendment without the full blessing of the Tuesday Group caucus.  House Republican leadership needs 216 votes.  Since no Democrats are expected to support the measure, Speaker Ryan can only afford to lose 22 members.

The Amendment allows states to waive certain ACA requirements.  States may apply for the following changes: read the full post here.


From ACG Practice Management Committee Chair, Michael S. Morelli MD, CPE, FACG

Important Date for ACG Members: May 15th for Sunshine Payment Review

The Centers for Medicare and Medicaid Services (CMS) has opened the “sunshine payment” review period.  The “Open Payments” program is required by the ACA.  CMS posts information about the payments that drug and device companies make to physicians and teaching hospitals, for expenses such as travel, research, gifts, speaking fees, and meals. It also includes ownership interests that physicians or their immediate family members have in these companies.  This data is then made available to the public each year on this website.

Review and Dispute is open now through May 15, 2017.  Learn more about the review, dispute and data correction process here.


 From ACG Governor for Northern California, Neil H. Stollman, MD, FACG

At the State and Local Level: Update on ACG Activities on State MOC Legislation

As ACG has kept you aware in recent policy alerts, the College is actively working with various state medical and GI societies in pursuing legislative efforts prohibiting onerous and unfair maintenance of certification (MOC) requirements.  The College believes in lifelong learning, by ongoing CME activities, rather than lifelong testing.  Stay tuned as ACG continues to work with more state medical and GI societies on MOC legislation.

California Members: State Senator Richard Pan, MD has introduced legislation that prohibits MOC as a condition for hospital privileges in certain circumstances.  ACG is working with the California Medical Association in promoting this bill.  Please contact Dr. Pan and express your support for SB 487!

SB-487 Practice of medicine: hospitals

ACG continues to be active in others states, collaborating with the state medical and GI societies, including, Tennessee, Massachusetts, and Texas.

Texas Members: The MOC bill passed the Texas Senate and is headed to the House.  It is expected that it will be referred to the House Public Health Committee sometime next week.  ACG continues to work with the Texas Society of Gastroenterology and Endoscopy (TSGE) on the bill. Please reach out the Chair of the House Public Health Committee, Rep. Four Price, and urge your support for HB 3216!


From ACG FDA Related Matters Committee Chair, Tedd P. Cain, MD, FACG

Biosimilars subject of Supreme Court Discussion

The U.S. Supreme Court heard arguments on Wednesday on biologic whether a biosimilar manufacturer must await FDA approval before providing the brand company a legally mandated 180-day notice of intent to market a competing product, and whether biosimilar companies have to engage in a patent-sharing process with the branded biologic manufacturer.  Supreme Court justices suggested that the best way to resolve disputes between brand and biosimilar companies over a law that allows the FDA to approve copycat biologics is to have the agency issue regulations before the disputes are interpreted by the high court.

CMS Notifications Forthcoming

This week, CMS announced plans to notify ACG members by late May if they must participate in MACRA’s Merit-based Incentive Payment System (MIPS).  Letters will be issued starting this week, and will come from Medicare Administrative Contractors.  ACG members must participate in MIPS if you bill Medicare Part B more than $30,000 and care for more than 100 Part B enrollees each year.  CMS released the draft template letter ACG expects to receive, along with some FAQs: