This Week – February 13, 2016

This Week in Washington, DC

  • President Obama’s FY 2017 Budget Proposal Includes Provision Eliminating Screening Colonoscopy Cost-Sharing
  • At the State Level: ACG Urges NY Members to Help Change NY Governor’s Budget Proposal
  • ACG Updates Member Guidance on 2016 Medicare Reimbursement and Quality Reporting

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

Budget Proposal Eliminates Coinsurance When Screening Colonoscopy Turns Therapeutic

On Tuesday, February 9th, President Obama released his blueprint federal budget for fiscal year (FY) 2017.  Each year, the President sends a recommended federal budget for congressional consideration.  GOP lawmakers quickly criticized the budget plan, announcing last week that they will skip the budget committees’ usual hearings over the President’s budget.

The budget includes two important provisions impacting ACG members and our patients:

  • Eliminate Beneficiary Coinsurance for Screening Colonoscopies with Polyp Removal.  Medicare beneficiaries are not subject to the Part B deductible or coinsurance for most recommended preventive and screening services, including screening colonoscopies.  However, if a screening colonoscopy results in removal of a polyp, ablation, or other procedure, beneficiaries are subject to 20 percent coinsurance, which presents a financial challenge for beneficiaries to receive care.  This budget proposal eliminates beneficiary coinsurance when the screening results in removal of a polyp or other procedure, thereby removing a significant barrier that beneficiaries face in receiving necessary preventive care.  [Estimated cost to Federal Government: $2.4 billion over 10 years]
  • Hepatitis C Treatment in People Living with HIV.  According to the budget proposal, people living with HIV are disproportionally affected by viral hepatitis and are at an increased risk for serious, life-threatening complications. The Administration estimates that one quarter of all people living with HIV are co-infected with hepatitis C, and the rate is even higher (80 percent) amongst people living with HIV who inject drugs. Given the changes in the health care environment and advances in hepatitis C Treatment, the FY 2017 Budget includes $9 million to expand screening and treatment of hepatitis C in people living with HIV.

Since Republicans have already decided this budget proposal is “dead on arrival,” ACG continues to urge Congress to pass the SCREEN Act.  The SCREEN Act (S. 1079, HR 2035) removes all financial barriers for Medicare beneficiaries throughout the screening continuum, so that cost-sharing would not apply, whether the colonoscopy was a preventive test or as the result of a positive finding from another screening modality.

Read my full post here.


ACG New York Governors Urge Members to Help Restore Medical Malpractice Coverage

NY.jpgAlso on Tuesday, February 9th, on a local level, ACG’s Governors for New York alerted NY members on a state budget proposal to reduce access to extra medical malpractice insurance coverage.  The Excess Medical Liability Insurance Program provides an additional layer of $1M of coverage to physicians in our state with hospital privileges who maintain primary coverage at the $1.3 million/$3.9 million level. Since its inception in 1985, the cost of the program has been met by utilizing public and quasi-public monies.  However, NY Governor Cuomo’s recent proposed Public Health Budget for FY 2016-2017 would significantly limit physician access to Excess Coverage and reduce its appropriation by $25M to $102.4M.

Remember to contact your ACG Governor on important state and local issues impacting you and your practice

The ACG Board of Governors is one of the most unique aspects of the American College of Gastroenterology. Governors are ACG Fellows that are elected from the membership of a particular state or region. There are currently 76 Governors across seven different regions in the U.S. and abroad. The Board of Governors acts as a two-way conduit between College leadership and the membership at-large. This helps the College make certain it is meeting the evolving needs of the membership.

Contact your ACG Governor today.


ACG Updates Medicare Reimbursement and Quality Reporting Guidance

Have questions on 2016 Medicare reimbursement rates or need guidance on participating in Medicare quality reporting programs?  Please visit ACG’s updated 2016 “Medicare Reimbursement and Quality Reporting Toolkit.”  This educational material is tailored for busy GI practices.