This Week – July 18, 2015

This Week in Washington, DC:

From National Affairs Committee Chair Caroll D. Koscheski, MD, FACG

National Affairs - Koscheski .jpg ACG and GI Societies to Fight Medicare Cuts to Colonoscopy

ACG and the GI societies are committed to fighting the proposed cuts to reimbursement rates for colonoscopy and other lower GI endoscopy procedures. We are scheduled to meet with CMS leadership next week. ACG continues to urge members of Congress to help oppose these cuts as well as cosponsor the SCREEN Act (S. 1079; HR 2035), which would maintain colonoscopy reimbursement at the 2015 levels and until the Medicare fee for service reimbursement system changes take place beginning in 2019. The SCREEN Act is currently the only legislation that deals with these changes to colonoscopy reimbursement.

Read my full post

Proposed Colonoscopy Reimbursement Rates for 2016

What You Can Do

ACG wants to share with CMS officials next week data on how cuts of up to 19 percent will affect GI practices. Please take the time and complete this quick poll and help us fight for fair reimbursement for you.

Urge congress to support the SCREEN Act

Proposed ASC Rule Includes Increases in Facility fees for Upper GI Procedures

The Centers for Medicare and Medicaid Services (CMS) also released the proposed rule that includes policy and payment changes for the Hospital Outpatient Prospective Payment System (HOPPS) and Ambulatory Surgical Centers (ASC) for calendar year (CY) 2016.

Highlights of the proposed rule include:

  • an increase facility fees for common procedures such as EGD, ERCP, and Esophagoscopy by 4 percent on average;
  • a major reorganization of all APCs resulting in the restructuring and consolidation of the APCs that contain GI procedures from 23 APCs to 13 APCs;
  • APC reassignment of four lower endoscopy stent procedures. CMS is proposing to accept our recommendation and plans to move CPT codes 44384 (Ileoscopy with stent), 44402 (C-stoma with stent), 45347 (Flex sig with stent) and 45389 (Colonoscopy with stent) to APC 5331 (Complex GI Procedures), resulting in payment increases for these services.

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