This Week – August 20, 2016

This Week in Washington, D.C.

  • ACG Member Call to Action: better valuation for E&M and cognitive services
  • ACG Member Safety Communication: FDA recommends to stop using Custom Ultrasonics system for reprocessing duodenoscopes
  • ACA Back in the News: a good time for some updated statistics for ACG members
  • MACRA Tidbit for the Week: don’t forget about the other ACG MACRA Tidbits!

ACG Member Call to Action: better valuation for E&M and cognitive services

In the April issue of Gastroenterology & Hepatology, Seymour Katz, MD, MACG and Gil Y. Melmed, MD call into question the Resource-Based Relative Value Scale (RBRVS) physician compensation model for cognitive services.  “The present RVU metric for compensating physicians is flawed,” write the authors.

CMS now proposes that in the CY 2017 Medicare physician fee schedule codes that will hopefully capture some of this physician work for cognitive services that, as noted by Drs. Katz and Melmed, are undervalued and fail to capture the range and intensity of nonprocedural physician activities.  CMS needs to hear from you to finalize this proposal for CY 2017.

Take these easy steps:

  1. Go to: https://www.regulations.gov/document?D=CMS-2016-0116-0006
  1. Select “Comment Now” (top right corner)
  1. Complete data fields and use the following suggested language.

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

ACG Member Safety Communication: FDA recommends to stop using Custom Ultrasonics system for reprocessing duodenoscopes

This week, the FDA released a public safety alert and advised users to stop using its System 83 Plus AERs for reprocessing of duodenoscopes. Based on the Agency’s February 2016 Safety Communication, at this time, facilities should have transitioned to alternative methods of reprocessing of duodenoscopes.

ACG hosts FDA safety alerts on the College’s website and encourages members to stay informed.  ACG will also continue to alert membership on important FDA news impacting your patients and your practice.


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

ACA Back in the News: a good time for some updated statistics for ACG members

This week, Aetna announced that the company intends to withdraw most of its “2017 public exchange expansion plans” and undergo “a complete evaluation of future participation in [its] current 15-state footprint.”  Aetna will exit markets in several states, including North Carolina, Pennsylvania, and Florida.  In most of these areas, Aetna will still offer individual coverage outside of the ACA exchanges.  The insurer will keep selling plans on state exchanges only in Iowa, Delaware, Nebraska, and Virginia.

According to reports, Aetna covers only 8% of ACA enrollees.  Aetna cited higher-than-expected medical costs as the reason for the decision. A month ago, however, Aetna also warned the U.S. Government that if the company were not allowed to merge with Humana, it might not be financially healthy enough to remain in the ACA health exchanges.  The U.S. Government has since moved to block the merger.  In July, 2016, Humana also announced that it is pulling out of the Marketplaces in all but a handful of states after a year of nearly $1 billion in losses.  In November 2015, the nation’s biggest commercial market insurance issuer, United Health Group, also announced that it would scale back its marketing efforts for products for 2016, and is contemplating leaving the Marketplaces entirely in 2017.

However, Kaiser Permanente also announced this week that it is “absolutely sticking with the exchanges over the long term,” and reminded the public how difficult the individual market was before the ACA went into effect.  To find the latest ACA statistics, please read the full blog here.

MACRAbanner

Don’t forget about the other ACG MACRA Tidbits!

Since the release of the proposed rule, ACG has focused on certain segments of this newly proposed Medicare payment system, delving more into the specifics but in piecemeal and in brief summaries.  This way, we hope the busy GI clinician is not overloaded with lengthy explanations, complicated flow charts, and more acronyms all at the same time.