SBH photo 2014
Stephen B. Hanauer, MD, FACG

Earlier this summer, the Centers for Medicare and Medicaid Services (CMS) proposed drastic cuts to the 2016 Medicare physician reimbursement rates for colonoscopy and other lower GI endoscopy procedures. ACG, AGA and ASGE are fighting for fair and accurate reimbursement for all lower endoscopy procedures, including colonoscopy.

Under the Physician Fee Schedule (PFS) proposed rule, physician work values for colonoscopy procedures are cut 13 percent on average.  When coupled with proposed cuts to ambulatory surgery centers, some practices could experience reductions of up to 20 percent.

Membership has asked us to work together and the sister GI societies are united in our goals to support gastroenterologists and to maintain fair assessments of our work efforts. As I pointed out in my July 9th message, the GI community in the United States needs to understand the fundamental lack of fairness behind the flawed process that got us to this flawed outcome. And, as I mentioned, worst of all, we risk a reversal of the progress our nation is making to increase use of colorectal cancer screening by colonoscopy for Medicare beneficiaries, who by virtue of their age, are at higher risk for colorectal cancer.

We need your help! Take action: tell CMS to reconsider the cuts 

CMS needs to hear the voices of gastroenterologists throughout the country as to how these cuts will affect Medicare patients and your practice. Send comments on the proposed fee schedule rule to CMS by Tuesday, September 8.

To comment:

  • Visit the official federal government portal for submitting public comments on the proposed rule here.
  • Copy and paste the template letter into the box labeled “Comment.”
  • If interested, supplement the letter with any of your personal experiences that you want considered.
  • Enter your individual contact information and press the blue “continue” button at the bottom of the page.
  • Review and submit.

Furthermore, support of the SCREEN ACT is critical to:

  1. Remove Financial Barriers for Medicare beneficiaries throughout the screening continuum, so that cost-sharing would not apply whether a polyp is removed during a screening colonoscopy or as the result of a positive finding from another type of screening test.
  2. Improve Quality by encouraging higher quality at time of lower reimbursement, which would result in more quality examinations for many Medicare beneficiaries and creates incentives to ensure that these patients receive the highest quality exams. The is the only bill in Congress specifically addressing colonoscopy reimbursement.
  3. Remove Emotional Barriers by creating an innovative Medicare demonstration project which authorizes a colonoscopy pre-screening visit and an opportunity for Medicare beneficiaries to ask questions, learn about the importance of pre-procedure preparation, and learn more about what to expect on the day of the procedure.
  4. Streamline Care Coordination by allowing the pre-screening visit to satisfy the current law’s hepatitis C referral requirement.
  5. Save lives by eliminating barriers to potentially lifesaving colorectal screenings for Medicare beneficiaries and ensuring they are screened regularly through a variety of recommended methods, including colonoscopy. The bill allows Medicare beneficiaries to schedule an age appropriate hepatitis C screening at the same time as the screening colonoscopy, thus promoting two important public health imperatives in the same encounter.

ACG President Stephen B. Hanauer, MD, FACG