Chair, ACG National Affairs
Last month, ACG updated membership on the outstanding issues that remained when members of Congress left for the August recess. Well, Congress comes back into session next Tuesday…. for a whopping 17 days, until they leave again to ramp up the campaign and election season. So what is ACG focusing on as we head into this session and post-election “lame duck” Congress to close out 2016?
Potential Delay in MACRA? As mentioned in previous posts, during a July 13 Senate Finance Committee hearing on MACRA implementation, CMS Acting Administrator Andy Slavitt suggested that federal officials are open to a possible delay of the timetable for implementing the proposed payment reforms. ACG has also urged CMS to delay MACRA in the College’s recent comment letter to the proposed rule. ACG has joined other stakeholders and is independently working with Congressional staff on the possibility of delaying MACRA until more details and guidance are released, giving ACG members and practices more time to prepare for this seismic change in Medicare reimbursement. This also affords staff an opportunity to discuss other areas of concern that are outlines in ACG’s MACRA comment letter, such as reducing burdens under the Advancing Care Information category (formerly known as Meaningful Use).
Legislation specific to GI: ACG continues to advocate for the SCREEN Act (S. 1079; HR 2035) and “Removing Barriers to Colorectal Cancer Screening” Act (S.624; HR 1220). These bills benefit both ACG members as well as our patients: better reimbursement for demonstrating better screenings, along with better cost-sharing for patients.
However, these bill are tough to pass. Important bills to ACG cost the Federal Government money. While the SCREEN Act is “budget neutral,” it is also specialty-specific. That’s why ACG is also advocating for the “Preventive Health Savings Act” (S.3126; HR 3660). We share the belief that the way in which the Congressional Budget Office (CBO) currently “scores” legislation (estimated costs to the Federal Government) severely constrains policymakers’ ability to assess legislation that both promotes preventive medicine and generates long-term savings to Medicare. Unfortunately, CBO rules do not allow it to make cost-savings estimates beyond 10 years. This is very important for two reasons. First, a better “CBO score” makes legislation important to ACG members and our patients easier to pass. Screening colonoscopy is demonstrated to not only reduce incidence rates and deaths from colorectal cancer, but also costs to the health care system. Secondly, more accurate CBO estimates give Congress less incentive to look towards legislation that ACG opposes, but CBO views as “cost savers,” to offset the costs of larger legislative packages rushed through Congress at the end of the year. For example, legislation that eliminates the in-office ancillary exception for services such as in-house anatomic pathology.
Other legislation impacting the clinical GI: ACG is also very active advocating for other bills that support your patients and reduce your practice management burdens.
Whitfield L. Knapple, MD, FACG
Chair, ACG National Affairs Committee