This Week – March 31, 2018

This Week in Washington, D.C.

  • ACG Co-hosts FDA GREAT V Public Workshop: thank you for participating!
  • Important Date for ACG Members: CMS Extends the MIPS 2017 Data Submission Deadline
  • Call to Action: ACG active on Step Therapy bills at state and federal level

ACG Co-hosts FDA GREAT V Public Workshop

On Tuesday March 28th, the ACG, American Gastroenterological Association (AGA), North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and FDA cosponsored the “Gastroenterology Regulatory Endpoints and the Advancement of Therapeutics (GREAT) Public Workshop on Pediatric Irritable Bowel Syndrome and Pediatric Functional Constipation.”  This is the fifth GREAT workshop ACG has cohosted with the FDA and others.

ACG thanks the FDA, the cosponsors, and speakers for all of their efforts in making this event another successful public workshop.

Click here for an overview of the agenda.  Stay tuned, as ACG plans to host the slides from the GREAT V workshop on the website in the near future.


From ACG Legislative and Public Policy Council Chair, Whitfield L. Knapple, MD, FACG

Important Date for ACG Members: CMS Extends the MIPS 2017 Data Submission Deadline

If you’re an eligible clinician participating in the “Quality Payment Program,” you now have until Tuesday, April 3, 2018 at 8 PM (EDT) to submit your 2017 MIPS performance data. You can submit your 2017 performance data using the new feature on the “Quality Payment Program” website.

As ACG has previously reported, ACG members can click here to begin the process.  Here are some last minute practical tips for GI practices and ACG members:

Your first step: Find out your status (you may not need to report data)

Determine whether or not you have to worry about MACRA/MIPS.  Click here and enter your 10-digit National Provider Identifier (NPI) number.  This will tell you whether you meet the thresholds in order to be required to participate in MACRA.  Who has to participate in MACRA for the 2017 reporting year?

  1. If you are a: physician, physician assistant, nurse practitioner, clinical nurse specialist, or CRNA; and
  2. If you bill more than $30,000 to Medicare, and provide care to more than 100 Medicare patients per year.

Your second step: If you meet the eligibility requirements and want to submit your data: read the full blog here.


Call to Action:
ACG active on Step Therapy bills at state and federal level

Please contact Congress on a very important patient advocacy and practice management issue. ACG has focused efforts to limit insurer “Step Therapy” requirements at both the federal and state level. Step Therapy entails the “fail first” drug therapy requirements, in which patients are forced by insurers to try and fail with one or more medications before the insurer approves the cost of the medication which ACG members originally prescribed. Representative Brad Wenstrup (R-OH) has introduced the “Restoring the Patient’s Voice Act of 2017” (HR 2077), which allows for exemptions for Step Therapy requirements in health plans regulated by federal law.

To help make an impact, your legislators need to hear from you directly, and the ACG website makes this process quick and simple. Use the link below to advocate your support.

All ACG members: click here to take action now!

ACG Governors and members continue to express their frustration over the amount of time and resources GI practices spend dealing with insurers and prior authorizations, at the detriment to patient care. These policies are not rooted in clinical evidence, and ultimately take valuable time away from treating patients.  ACG continues to stress the importance of protecting the sanctity of the patient-physician relationship.  Results from a December 2017 survey of 1,000 practicing physicians show the negative effect of Prior Authorizations:

  • Physician practices continue to wait for an answer from insurers: 64% reported waiting at least 1 day for Prior Authorization decisions from health plans, while 30% reported waiting at least 3 business days.
  • These wait times translate into patient care delays: 92% of physicians saying that Prior Authorization delays access to necessary care, and have a negative impact on patient clinical outcomes.
  • These delays have serious implications for patients: 78% of physicians reported that Prior Authorizations can lead to treatment abandonment.

The survey also addressed the burdens imposed on physician practices:

  • Physician practices complete an average of 29 Prior Authorizations per week, per physician.
  • This workload requires 14.6 hours —nearly two business days per week— of physician and staff time, and time away from patients.
  • 84% of physicians characterized Prior Authorization-related burdens as high or extremely high. 86% of physicians reporting that PA burdens have increased over the past 5 years.

ACG Members in Massachusetts: Urge your state legislators to support the “Acts to Reduce Health Care Costs Through Improved Medication Management” (S.551 and H.492), introduced in both the House and Senate, by State Representative Jennifer Benson (D-MA) and State Senator Barbara L’Italien (D-MA).  These bills also address problems with insurer step therapy requirements.  ACG is working with the Massachusetts Gastroenterology Association and other stakeholders in support of this important issue.

ACG members in Massachusetts: click here to take action now!