This Week – August 27, 2016

This Week in Washington, D.C.

  • At the State Level: Call to Action on CA Bill Seeking to Waive Patient Cost-Sharing for Therapeutic and Diagnostic Screening Colonoscopy
  • More at the State Level: New England States Pass Restrictions on Physician Non-Compete Agreements
  • At The Federal Level: MACRA Tidbit for the Week

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

Update on CA Bill Seeking to Waive Patient Cost-Sharing for Therapeutic and Diagnostic Screening Colonoscopy

This month, the California State Senate and Assembly passed the, “Health Care Coverage: Colorectal Cancer Screening and Testing (AB 1763).”  This bill, introduced by CA State Assemblyman Mike A. Gipson, has been endorsed by ACG as it shares the College’s goals of removing the financial and structural barriers associated with lifesaving colorectal cancer screenings throughout the screening continuum.

ACG urges CA members to reach out to Governor Brown and urge him to “please sign AB 1763 (Gibson) into law.”  You can e-mail the Governor here, or call/fax his office to express your opinion:

Governor Jerry Brown
c/o State Capitol, Suite 1173
Sacramento, CA 95814
Phone: (916) 445-2841
Fax: (916) 558-3160

We need CA patient advocates: ACG is also working with stakeholders to find patient advocates in CA who are willing to highlight their personal experiences of being impacted by colorectal cancer screening cost-sharing.  Please contact ACG now in order to get these patients involved.

We will continue to keep our members up-to-date on the bill’s status, along with any similar legislation across other states.

Consistency at the state and federal level: Read the full blog here.

From ACG Board of Governors’ Chair, Immanuel K. H. Ho, MD, FACG

Update from New England States: Connecticut and Rhode Island Pass Restrictions on Physician Non-Compete Agreements

This summer, Rhode Island and Connecticut passed significant legislation concerning the use of non-compete agreements for physicians.  The goal of restrictions on non-compete agreements is to give physicians significantly increased flexibility and mobility in their professions. These laws are also intended to promote the public interest on the theory that such non-compete agreements may inhibit patients’ access to the medical care of their choice.  Unfortunately, the Massachusetts’ legislature failed to pass a similar physician non-compete prohibition despite significant support.

ACG Practice Management Resources
Need advice on understanding the components of a non-compete agreement, and tips on protecting yourself from a bad scenario?  Check out AJG’s A Brief Introduction: THE NON-COMPETE AGREEMENT authored by Raj Majithia, MD.

To see the details of these two bills, please read the full blog here.


The “Clinical Practice Improvement Activity” of MIPS: Opportunity to get credit for something you are already doing?

The Clinical Practice Improvement Activity (CPIA) category will make up 15% of your MIPS score beginning in 2019.  Unlike other MIPS categories, however, the CPIA score will remain at 15% beyond 2019 as well, comprising a very small portion of your overall MIPS score.  So shouldn’t you get credit for similar activities you are already doing?  ACG thinks so, and here’s why:

CMS has stated the goal of MACRA includes eliminating duplicative reporting activities and reducing practice management burdens among clinicians.  ACG is committed to this goal as well.  We know that ACG members are burdened with red tape and different types of “CPIAs” (clinical-political improvement activities).

MACRA defines a clinical improvement activity as “an activity that relevant eligible clinician organizations and other relevant stakeholders identify as improving clinical practice or care delivery, and that the Secretary determines, when effectively executed, is likely to result in improved outcomes.”  Providers would select from a list of 90 proposed CPIAs in the proposed MACRA regulation, including activities focused on “Expanded Practice Access,” “Population Management,” “Care Coordination,” “Beneficiary Engagement,” “Patient Safety and Practice Assessment,” “Participation in an APM or Medical Home,” “Achieving Health Equity,” “Emergency Preparedness and Response,” and “Integrated Behavioral and Mental Health.”  ACG members must perform CPIAs for at least 90 days during the performance period for credit, and would submit them via a CMS internet portal or other reporting mechanisms.  Learn more about CPIAs here.

In order to help facilitate this shared goal of reducing practice management burdens, ACG believes our members should receive credit for participating in continuing medical education (CME) activities that are designed to further these CPIA objectives.  Accredited CME activities not only involve assessment and improvement of patient outcomes and quality of care, but there is an existing system in place that collects your CME activities in which GI clinicians already know how to use with familiarity . What’s more, while CMS does recognize registry participation as a “CPIA,” if your practice chooses to make the financial and practice management investment in a quality improvement registry, such as GIQuIC, then these activities should be more heavily weighted than what is currently proposed for this category.

Clearly, these activities meet this definition of a “clinical improvement activity” as defined in MACRA, and would further reduce practice management burdens among GI clinicians.

More on MACRA: ACG Hopes to Keep This Simple.   We compiled a detailed overview for you, hopefully in a simplified fashion and in plain English.  Read the summary and potential impact to GI: Making $ense of MACRA

The 2016 ACG Annual Scientific Meeting and Postgraduate Course will also delve into the details of these changes, as well as offer strategies and insight on how to adequately prepare your practice for these upcoming changes.