H.R. 1570 Reaches Important Milestone of 290 Cosponsors! Thank You ACG Members for Your Continued Advocacy!
The Removing Barriers to Colorectal Screening Act of 2019, (H.R. 1570 and S. 668) achieved an important milestone of securing over 290 supporters in the U.S. House of Representatives.
Thank you for lending your voice to support this bill!
Why Your Help Matters Now: According to the U.S. House of Representatives Rules Committee, Speaker Pelosi and the U.S. House must consider one bill (at a minimum) from the “Consensus Calendar” each session week. For a bill to be eligible for the Consensus Calendar, a measure must accumulate 290 cosponsors for at least 25 legislative days. While a vote is not guaranteed just for meeting the criteria, not many bills will meet this threshold, thus improving the likelihood of consideration.
Please urge U.S. House leadership to pass this bill as soon as possible!
CMS is Making Things Worse: CMS recently released the CY 2020 proposed regulation on the Medicare physician fee schedule payment changes. In this rule, CMS seeks comment on whether ACG members should be required to notify patients of the cost-sharing implications prior to performing a screening colonoscopy, and then document these notifications in the medical record. CMS also seeks comment on how to monitor and audit compliance. ACG and the GI societies oppose this proposal. ACG members would be subject to additional audit and compliance requirements due to a problem that CMS and Congress can easily resolve.
A Recent Review of Medicare Fee-for-Service Claims Emphasizes the Need for Congress to Pass H.R. 1570 and S. 668.
ACG and the Moran Company recently reviewed Medicare claims data from 2011 to 2017 and found that the incidence of polypectomy during screening colonoscopy is increasing dramatically. This is good news. For each percent increase in pre-cancerous polyp detection, there is a 3 percent reduction in CRC incidence and a 4 percent reduction in CRC death.
Thanks to the improved quality of CRC screening procedures, gastroenterologists have improved adenoma detection rates. At the same time, CRC incidence rates in the Medicare-age population have been declining as well.
Quality is Improving!
... But Medicare Beneficiary Liability is Increasing with the “Post-Polypectomy Surprise”
Due to a quirk in federal law, Medicare will cover the full cost of a "screening" colonoscopy. However, when a polyp is detected and removed, this "therapeutic" procedure is no longer considered a "screening" for coding and reimbursement purposes. Thus:
- Medicare beneficiaries incur surprise out-of-pocket medical costs.
- This is counter to the U.S. public healthcare goal of removing barriers to increasing CRC screening rates.
In April 2019, 100 ACG Governors and member of the ACG Leadership advocated for the Removing Barriers bill and other important issues impacting your GI practice and patients.
How Can You Get Involved?
ACG's Legislative Action Center: How can you get more involved?
What are some important bills impacting GI in Congress? In your state? How can you easily voice your support?
ACG's Legislative Action Center is your one-stop resource to review and advocate for various federal and state bills impacting your profession, practice, and patients.
Roadmap For a Successful Community or Academic GI Practice Course: Ramp-Up Your Practice, Super-Charge Your Staff
What is the Practice Management Toolbox?
Gastroenterologists in private practice find themselves working in a time of unprecedented transformation. Pressures are high as they make important management decisions that profoundly affect their business future, their private lives, and their ability to provide care to patients. The ACG Practice Management Committee has a mission to bring practicing colleagues together to explore solutions to overcome management challenges, to improve operations, enhance productivity, and support physician leadership. It was in this spirit that the Practice Management Toolbox was created.
The Toolbox is a series of short articles, written by practicing gastroenterologists, that provide members with easily accessible information to improve their practices. Each article covers an issue important to private practice gastroenterologists and physician-lead clinical practices. They include a brief introduction, a topic overview, specific suggestions, helpful examples and a list of resources or references. Each month a new edition of the Toolbox will be released and will then remain available here along with all previous editions. The Practice Management Committee is confident this series will a provide valuable resource for members striving to optimize their practices.