This Week – October 28, 2017

This Week in Washington, D.C.

  • Reducing Regulatory Burdens: ACG has a seat at the table for new CMS initiative, “Patients Over Paperwork”
  • Speaking of regulatory burdens: Help us help you! Please Provide Feedback to CMS on MACRA’s GI “episode of care”
  • At the State and Local Level: OH MOC Bill Hearing- We need OH Members to Voice your Support!

From ACG Legislative and Public Policy Council Member and Past ACG Board of Trustee, R. Bruce Cameron, MD, FACG

Reducing Regulatory Burdens: ACG has a seat at the table for new CMS initiative, “Patients Over Paperwork”

This week, the Centers for Medicare and Medicaid Services (CMS) announced the new initiative to reduce the regulatory burdens impacting patient care and the practice of medicine.  The “Patients over Paperwork” initiative formalizes CMS’ ongoing review of the unnecessary and burdensome challenges to patient care and physician practices.  ACG was invited to participate in this dialogue, continuing our advocacy on behalf of clinical GI and ACG members.

On Monday, Bruce Cameron, MD, FACG met with CMS Administrator Seema Verma and others to discuss the importance of reducing regulatory barriers for GI practices, as well as important policy changes required from MACRA.  Dr. Cameron and the Academy of Medicine of Cleveland & Northern Ohio (AMCNO) were part of a listening session panel at University Hospital Systems in Cleveland.  Dr. Cameron conveyed ACG’s message regarding the importance of changing the Cost/Resource Use performance category before the weight is increased to 30% of the total MIPS score, despite measures still being tested (see below re: needing your help).  Dr. Cameron also provided burden estimates and cost data to highlight the challenges ACG members must bear in everyday practice.

ACG was invited to join CMS Administrator Verma again on Thursday to continue this discussion on burden reduction and regulatory reform.  ACG echoed these concerns, and cited specific examples of ways to improve the regulatory burden borne by ACG members and clinicians.  Some fascinating data points from Thursday’s meeting emphasize why ACG has placed the reduction of regulatory burdens among the College’s most prominent public policy objectives over the past years:

  • Businesses in the U.S. spend over $1.9 trillion in costs annually in order to meet federal regulations.
  • According to CMS Administrator Verma, 40% of all federal regulations come from CMS.  CMS produces roughly 11,000 pages of federal regulations each year.
  • CMS understands onerous federal regulations are one key reason for physician burnout.  According to CMS, an estimated 17% of physician work is comprised of non-patient related paperwork.  As reported by the American Academy of Family Physicians, this time spent completing administrative work is estimated to be significantly higher than projected by CMS (closer to 30%).
  • In addition to an estimated 4 hours per week and over $40,000 per year spent on quality reporting programs, the average physician must deal with an estimated 37 prior authorizations and administrative requirements weekly.


ACG has been at the forefront of these efforts, advocating for reducing clinician burdens since MACRA was initially passed in 2015 and finalized in 2016.  These efforts include: educating CMS on the burdens associated with MACRA in both Year 1 and Year 2 Quality Payment Program/MACRA regulations, providing real-world examples of these burdens to members of Congress during the 2016 and 2017 ACG Board of Governors Washington D.C. fly-ins, and educating HHS officials on the burdens of mandating patient satisfaction surveys in Medicare facility reporting.  ACG has also recently urged CMS to exclude those GI practices located in areas hit by this year’s devastating hurricanes from MIPS requirements.


From ACG Legislative and Public Policy Council Member and ACG Board of Trustee, Caroll D. Koscheski, MD, FACG

Medicare Seeks Your Feedback on MIPS Colonoscopy Episode

As ACG and the GI societies notified you earlier this month, CMS recently announced that it will begin a trial run or test period for a “Screening/Surveillance Colonoscopy” episode of care.  We need your feedback and input!

What does this mean? 

From October 16 to November 15, 2017, ACG members may receive a confidential report with information about their performance on this draft episode of care.  According to CMS, the report is available for group practices and solo practitioners who meet a 10-episode case minimum during the measurement period of 06/01/16 to 05/31/17.

The purpose of this report is to help improve the accuracy and understanding of the process, and for our members to provide feedback to CMS.

Your Feedback is Important- Complete the Survey

CMS will be seeking feedback from all stakeholders through an online survey.   Please complete this survey here.

This survey opened on October 16, 2017 and closes at midnight on November 15, 2017.  The field test reports for group practices and solo practitioners will be distributed through the CMS Enterprise Portal, which CMS has previously utilized for “Quality and Resource Use” Reports.   If you do not already have an account, you can set one up and get access to a “Physician Quality and Value Programs” role in preparation for the field test report by using this guide.

Some background- Why do we need to do this? Click here to read the full blog.


OH MOC Bill Hearing- We need OH Members to
Voice Your Support!

This week, the OH State Legislature House Committee on Health held an “opposition” hearing on HB 273, the Patient Access Expansion Act.  This bill prohibits maintenance of certification (MOC) as a precondition for state licensure, hospital privileges, employment, and reimbursement.  We need you to reach and counter this opposition.  Please voice your support!

On Wednesday, Oct 11th, ACG Past President, Carol Burke, MD, FACG and ACG Governor for Southern Ohio, Christopher South, MD, FACG testified before the Ohio House Health Committee in support of HB 273.  Through the ACG Board of Governors and ACG Task Force on MOC, the College has been very active on the front lines, as MOC-related bills are being introduced and passed in state houses across the country.  Drs. Burke and South urged the Health Committee to support HB 273, highlighting the lack of clinical relevance of MOC closed-book exams, as well as the frustration and anger associated with MOC’s impact on the physician’s ability to practice medicine.  Drs. Burke and South emphasized the difference between MOC versus the value and importance of initial board certification and continuing medical education.

ACG remains committed to promoting high quality of patient care through lifelong learning, as opposed to lifelong testing.  ACG will continue to work with state legislators in Ohio to help get this bill passed.  ACG is here to help other states nationwide, as well.  Please use the ACG Legislative Action Center to support ongoing efforts in your states, and encourage your state medical and/or state GI society to get involved in introducing MOC legislation in your respective states.

Take action now!