This Week – September 14, 2013

This Week in Washington DC:

  1. The Latest on Health Reform and Insurance Exchanges: An Update on Your State
  2. ACG Participates in FDA Public Hearing on CT Colonography
  3. ACG Submits Comments to CMS on Proposed Fee Schedules

ACG presentation on health reform and issues impacting your practice
An important provision in the Patient Protection and Affordable Care Act (or “ACA”) is right around the corner. Beginning October 1st, states must have their health insurance exchanges fully operational. Individuals and small businesses (including GI practices) should be able to compare health plans’ coverage and costs, and then have the option to enroll into a plan effective January 1, 2014. What is your state doing? How will this impact your practice? The ACG National Affairs Committee has gathered the latest information on health insurance exchanges, Medicaid expansion, and how these forthcoming changes impact the GI practice.

Please click here to view this presentation.

ACG and ASGE participate in FDA hearing on CT colonography
On Monday, September 9th, the U.S. Food and Drug Administration (FDA) held a public hearing on the safety and effectiveness of computed tomography (CT) colonography for the asymptomatic patient. ACG thanks Douglas Rex, MD, MACG, who presented before the panel on behalf of ACG and ASGE. While the panel concluded that CT colonography should be used as a colorectal cancer screening mechanism, Dr. Rex reminded the panel of the inconsistent conclusions in the medical literature as well as the risks associated with cumulative exposure to ionizing radiation. It should be noted that ACG’s guidelines on colorectal cancer screening agree that CT colonography plays an important role in colorectal cancer screening and prevention. However, as Dr. Rex noted in his presentation, only polypectomy prevents cancer. That is why the gold standard for colorectal cancer screening is still complete optical colonoscopy. A noted gastroenterologist on the panel also reminded colleagues that with colonoscopy “we are preventing today that which we would be detecting in the future.”   

ACG will continue to engage the FDA and policy makers on this issue. Please click here to access ACG-ASGE’s comments to the FDA.

Please click here for more background on this hearing and to read a summary of the panel discussion.

ACG Joins AGA and ASGE in Submitting Comments to CMS
On Friday, September 6th, ACG joined its sister societies in submitting comments to the 2014 proposed Medicare regulations on the physician fee schedule and outpatient facilities. The Centers for Medicare and Medicaid Services (CMS) released these proposed rules in July. The final rules are expected in the first week of November.

Please stay tuned as ACG anticipates the final regulations to include more information on GI reimbursement. That is why ACG is actively engaging both CMS and Congress on your behalf.   

The GI societies’ comments focused on important issues impacting membership, including:

  • The Physician Quality Reporting System (PQRS), Value-Based Purchasing Modifier (VBPM), and the Ambulatory Surgical Center (ASC) Quality Reporting Program – reducing burdensome Medicare quality reporting requirements and incorporating quality measures meaningful to GI.
  • Clinical Quality Improvement Registries – promoting and aligning Medicare quality reporting programs with the option of participating in registries such as GIQuIC.
  • Medicare Beneficiary Screening Colonoscopy Cost-Sharing – eliminating barriers to colorectal cancer screening by waiving patient cost-sharing for screenings that turn into therapeutic procedures.
  • “Misvalued” Physician Fee Schedule (PFS) Codes – requesting that the CMS continue to work with the societies during ongoing GI procedural code reviews, especially since colonoscopy has been unfairly targeted and mischaracterized in recent New York Times and Washington Post articles.
  • Physician Compare – improving the accuracy of the ‘Physician Compare’ website and requesting that CMS include voluntary quality improvements initiatives and other quality metrics developed by societies on the physician’s individual profile.
  • ASC Inflation Update – requesting CMS determine annual ASC updates under the same inflationary index used to determine annual updates in the outpatient hospital department (HOPD) setting.

Please click here to read the societies’ letters on proposed changes to the Medicare physician fee schedule, on promoting the use of quality clinical improvement registries, as well as the proposed changes to the ASC/HOPD settings.

Please stay tuned for further updates. Please also share and discuss your thoughts with fellow ACG members on the ACG GI Circle. To login and share your comments, go to and sign in as a member. Once you have done so, click here and then click the orange "Visit ACG GI Circle" button to be taken to the GI Circle site. If you have not yet activated your ACG GI Circle account, please email us at

Contact Brad Conway, VP Public Policy, with any questions or for more information.

Brad Conway