This Week – May 14, 2016

This Week in Washington, D.C.

  • GIQuIC: 3 million colonoscopies and counting!
  • At the State and Local Level: ACG and MSSNY Opposing NY Legislation on Medical Malpractice
  • ACG Fighting CMS and Working with Congress on Medicare Physician-Administered Drug Reimbursement Proposal
  • ACG’s MACRA Tidbit of the Week

From ACG Vice President, Irving M. Pike, MD, FACG

GIQuIC: the Bridge Between Public Policy and Practice Management

This week, GIQuIC announced that the registry database has surpassed 3 million colonoscopies.  The growth in procedures has been driven by a surge in the growth of the number of practices and physicians involved in this quality improvement initiative. More than 4,000 providers, which account for over a quarter of all U.S. gastroenterologists, now participate in GIQuIC – a number that has grown by 500 providers since last fall.  Click here to read the announcement.

The GIQuIC registry has again been approved as a Qualified Clinical Data Registry (QCDR) for individual providers reporting to the Physician Quality Reporting System (PQRS).  For 2016, providers who satisfactorily participate in PQRS will avoid the 2018 payment cut of 2%, a cut that could be up to an additional -4% via the “value-based payment modifier” (depending upon group size).

ACG does not endorse simply linking reimbursement to quality reporting.  However, in the event that state and federal policymakers mandate quality reporting as a condition to payment, it is ACG’s goal to minimize practice management burdens and protect GI reimbursement as much as possible.

GIQuIC and the forthcoming “Merit-Based Incentive Payment System” (MIPS).

Click here to learn more about signing your practice up for GIQuIC.

KatzMelmed From ACG Governor for Southern New York, Brad M. Dworkin, MD, FACG

ACG New York Governors Urge Members to Oppose Medical Malpractice Bill

This week, ACG’s New York Governors alerted NY members about a state bill seeking to change medical malpractice rules.  ACG has been actively working with the Medical Society for the State of New York (MSSNY) and urging members to oppose legislation (A.285-A, Weinstein/S.6596, DeFrancisco) that could increase New York’s already significant medical liability premiums.  The bill changes the Statute of Limitations to a “Date of Discovery” rule.  If enacted, according to MSSNY, this legislation could increase premiums by nearly 15%.

Read the full blog post here.

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

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

Medicare Part B Drug Reimbursement Proposal Would Cut Reimbursement for GI Practices and Infusion

This week, ACG submitted formal comments to CMS regarding an ill-advised proposal to change the reimbursement formula for physician-administered drugs, such as infliximab and vedolizumab.  ACG is also a member of like-minded coalitions of providers in opposition to this proposal.  Many patient advocacy groups, such as the Digestive Disease National Coalition (DDNC), also oppose this payment change.

ACG is also engaged and working with allies in Congress by promoting a bill sponsored by Rep. Larry Buchson (R-IN).  This bill would prevent CMS from going through with this proposal.

Read the full blog post here.

MIPS or “The Other Guy Must Fail First”
Payment System

In the upcoming days, ACG will focus 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.

MACRA requires “Budget Neutrality.”  This means the MIPS bonuses are to be proportional to cuts.  The total amount paid out must be equal to the total amount of penalties assessed to achieve budget neutrality.  CMS estimates that MIPS payment adjustments would be equally distributed between the cuts ($833 million) and bonuses ($833 million) to MIPS eligible clinicians.  For GI, CMS estimates that roughly 62% would be eligible for a bonus and 38% would be subject to a payment cut.   This means that there must be low scoring providers to have the available bonuses for higher scoring ACG members.

Check out ACG’s “Making $ense of MACRA” summary for more analysis of MIPS and APMS.