On April 16th, ACG’s Board of Governors, Early Career Leadership Program participants, and other senior ACG leaders will head to Capitol Hill for our 2026 Advocacy Day.
Last week, we previewed our push to pass the Safe Step Act and rein in prior authorization abuse. As a reminder, this year’s theme is ‘Advocacy Takes Guts: Advancing Digestive Health’ – which couldn’t be more fitting, because standing up to a Medicare reimbursement system that has shortchanged physicians for decades takes exactly that.
Adjusted for inflation in practice costs, Medicare physician reimbursement has declined by 18% between 2015 and 2026. For GI clinicians, common diagnostic and screening colonoscopy codes have also been cut by roughly 12%, and that’s just since 2022. And while hospitals, outpatient facilities, and virtually every other Medicare provider category receives an automatic, inflation-based payment update each year, physicians are the only Medicare providers who do not. The result is a system that asks GI clinicians to absorb rising costs year after year with no relief in sight.
Compounding the lack of inflation adjustments is Medicare’s budget neutrality provision, an unwarranted statutory relic that has not been updated since 1992. Under this provision, overall Medicare physician reimbursement cannot exceed a baseline set more than 30 years ago. That means any increase for one specialty triggers cuts to another, a “robbing Peter to pay Paul” paradox that guarantees annual legislative crises and leaves practices in a state of financial uncertainty.
In 2026, CMS made the situation worse when it introduced the ‘efficiency adjustment’, an ongoing, annual 2.5% cut to work RVUs for all procedures, like colorectal and esophageal cancer screening. The policy has no clinical merit, instead relying on the faulty premise that clinicians simply become more efficient over time and should therefore be reimbursed less for the same work. ACG proudly endorses the Efficiency Adjustment Delay Act (H.R. 7520), which is on our Advocacy Day agenda and would reverse this policy entirely.
For years, Congress has placated physicians and patients, and ACG members are experiencing the consequences of this inaction: practice consolidation, physician burnout, and shrinking access to GI care across the country. In underserved areas, where physician-led practices are often the only option, the stakes are especially high.
That’s why our Advocacy Day delegation will also urge Congress to pass the Provider Reimbursement Stability Act (H.R. 8163), which was introduced earlier this week by Rep. Greg Murphy, MD (R-NC) and a bipartisan group of lawmakers. The bill would raise the long-outdated budget neutrality threshold and limit the volatility of year-to-year conversion factor swings – bringing some stability to a system that we all know hurts patients and physicians alike for decades.
You don’t need to be in Washington to make a difference. Reach out to your Representative and Senators today, urge them to co-sponsor H.R. 8163, and share your own story of how Medicare reimbursement cuts are affecting your patients and your practice. Nobody will advocate for GI care if we don’t.