This Week – May 13, 2017

This Week in Washington, D.C.

  • Health Reform Update: Awaiting Action in Senate
  • At the State and Local Level: An Update from the ACG MOC Task Force
  • MACRA Tidbit for the Week: Am I included in MIPS?

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

Health Reform Update: Awaiting Details in Senate

As ACG reported last week, the fight to repeal the Patient Protection and Affordable Care Act (ACA) now heads to the U.S. Senate, where Republican Senators have already distanced themselves from the House-passed American Health Care Act (AHCA).

Republican leaders in the U.S. Senate are awaiting an official Congressional Budget Office (CBO) score of the House-passed AHCA, but the CBO announced this week that they will not likely release updated estimates until the week of May 22nd.  The CBO completed its initial analysis of the AHCA on March 13, 2017, and subsequently updated their analysis on March 23, 2017.  The recent changes to appease groups within the House Republican party are obviously not accounted for in the March 2017 CBO scores.

According to reports, there is support among Senate Republicans to focus tax credits in any repeal package to an individual’s income, with more generous subsidies for lower income individuals.  If true, it is uncertain how these changes will sit with U.S. House Republicans. The House-passed AHCA increased tax credits by age.  Of note, if basing premium assistance on income sounds familiar, it’s because this is how premium assistance is currently determined under the ACA. It also has been reported that the Senate Republican plan would also boost support for individuals aged 50 to 64, or for those just shy of Medicare eligibility.

Stay tuned for further updates.  ACG is actively working with members of the U.S. Senate to ensure GI patients with pre-existing conditions are protected, as well as cost-sharing for essential health benefits and preventive services such as colorectal cancer screening.

From ACG MOC Task Force Chair, Daniel J. Pambianco, MD, FACG

At the State and Local Level: An Update from the ACG MOC Task Force

As ACG President Dr. Carol A. Burke wrote in March, ACG has heard the discontent and significant concerns of its members about ABIM’s new proposals for Maintenance of Certification (MOC) and their potential to generate a “broad-based, perpetual testing scenario.”  The College is committed to working actively on your behalf with ABIM to shift the focus of the high stakes MOC test into a process of lifelong learning that is more relevant to clinical practice.

ACG is also exploring alternatives at the state and national level, working collaboratively with state GI and medical societies, as well as other like-minded organizations.  I am honored to be spearheading this work group and coordinating efforts with the ACG Board of Governors.

The State of the States
I wanted to provide an update on this work with the ACG Governors, and steps you can take to help spread awareness in your state.

ACG has sent various action alerts to members throughout this year, urging you and colleagues to support state bills that prevent MOC as a condition to licensure, hospital privileges, employment, and/or reimbursement.  We continue to collaborate with state societies and we need to your support.

We need your help!
ACG has compiled an updated list of bills in statehouses across the U.S.  This list also provides ACG members a mechanism to express support with the state legislators sponsoring these bills. Embedded in the document are direct email links to send a message to elected representatives in your state.  Please review and express your support!

Am I included in MIPS?

This week, CMS reported that 806,879 clinicians will not be evaluated under MIPS in 2017.  That’s an increase from the October 2016 prediction that 780,000 clinicians would not have to comply with MIPS requirements.  CMS also previously estimated that 642,000 physicians were subject to reporting MIPS data, but that number has now dropped to 418,849.

Find out your status:

CMS this week released an online tool to help ACG members and others determine whether or not you need to participate in MIPS this year.  Click here and enter your 10-digit National Provider Identifier (NPI) number.

If you’re exempt from MIPS with the first review, you won’t need to do anything else for MIPS this year.  CMS will do another round of reviews later in 2017.  If you are included in MIPS, you may be exempt with the second review of eligibility determinations at the end of 2017.

Who has to participate in MACRA?

  1. If you are a: physician, physician assistant, nurse practitioner, clinical nurse specialist, or CRNA; and
  2. If you bill more than $30,000 to Medicare, and provide care to more than 100 Medicare patients per year.

CMS estimated that roughly 12,168 GI clinicians would be subject to MIPS in 2017.  Do you have to participate?  Click here.

ACG members are encouraged to use the various MACRA resources, including the detailed overview of MACRA, “ACG’s “Making $ense of MACRA,” the ACG-CMS webinar on MIPS program, ACG’s “quality reporting checklist,” a list of each measure in the MIPS Quality, Advancing Care, and Improvement Activities categories, as well as each measure’s specifications. Check out the comprehensive list of ACG’s “MACRA Tidbit for the Week” here as well.

Learn more about MIPS eligibility by visiting the CMS “Quality Payment Program” website.