This Week – February 20, 2016

This Week in Washington, DC

  • CMS and Private Health Insurance Groups Seek to Align Quality Reporting
  • At the State and Local Level: ACG Endorses CA Bill to Waive Patient Cost-Sharing for Therapeutic and Diagnostic Screening Colonoscopy
  • Dr. Michael Morelli Invites you to View the ACG 2015 Practice Management Course

National Affairs - Knapple .jpg From National Affairs Committee Chair, Whitfield L. Knapple, MD, FACG

CMS and Private Insurers Propose Measure Sets to Include GI Measures

On Tuesday, February 16th, the Centers for Medicare and Medicaid Services (CMS) announced a new set of proposed quality measure groups meant to make reporting requirements “more consistent and efficient” in both the public and private health insurance markets.  The Core Quality Measure Collaborative is led by CMS and America’s Health Insurance Plans, an industry trade group for private health insurers.  According to reports, “by easing the reporting complexity for clinicians, insurers are also hoping to bring down costs for themselves and consumers.”

The core measures announced on Tuesday will affect 7 areas, including: primary care, cardiology, gastroenterology, HIV and hepatitis C, medical oncology, obstetrics and gynecology, and orthopedics.  Click to read the announcement and information on the gastroenterology measure set.

What does mean for you?

Right now, there are no requirements or changes to the current quality reporting programs.  In the near future, CMS hopes the new measurements will be adopted by both CMS and private insurers.  Please note that measures in the GI set are already part of the Physician Quality Reporting System (PQRS).  However, moving forward, changes may be on the horizon in the private insurance market.  Contact your ACG Governor if you hear that this may be happening in your state.

Read my full post here.

Stollman.jpgFrom ACG Governor for Northern California, Neil H. Stollman, MD, FACG

ACG Endorses CA Bill to Waive Patient Cost-Sharing for Therapeutic and Diagnostic Screening Colonoscopy

On behalf of the College, ACG Governors for California endorsed a bill introduced by CA State Assemblyman Mike A. Gipson, “Health Care Coverage: Colorectal Cancer Screening and Testing” (bill number: AB 1763). This legislation, which eliminates financial and structural barriers to lifesaving colorectal screenings, shares the goal of the SCREEN Act and the College’s advocacy efforts before the U.S. Congress.  The bill removes financial barriers throughout the “screening continuum,” so that cost-sharing would not apply, whether the colonoscopy was a preventive test or as the result of a positive finding on another screening modality.  The state legislature in Oregon recently passed a similar bill.

ACG members in CA: Please click here to contact Assemblyman Gipson to express your support for AB 1763.

The SCREEN Act (S. 1079; HR 2035) also reverses recent cuts to colonoscopy in Medicare.  Please click here to express your support for the SCREEN Act.

Morelli .jpgStand-out Topics from 2015 Practice Management Course in Honolulu:

Promoting your practice through innovative marketing techniques; Strategies for negotiating with hospitals

The 2015 Practice Management Course in Hawaii was directed by Dr. Joseph Cappa and Dr. William Stern who organized an excellent program, “Riding the Wild Surf of the Ever-Changing Medical Environment: Can You Maximize Value in Your Practice? How Can You Use Negotiation Techniques to Avoid the Dreaded Wipeout?”  The intent was to provide practitioners with both a broad-based understanding of the current GI practice landscape, and to provide focused recommendations on how to improve the clinical and business aspect of their practices.

Please read the full blog here.