This Week in Washington DC – December 19, 2020

From ACG Legislative and Public Policy Council Chair, James C. Hobley, MD, MSc, FACG

A slew of ACG public policy priorities were on the docket this week as Congress rushes to pass an appropriations package to keep the federal government open and pass another COVID-19 relief package, along with other year-end bills. Last night, Congress passed a two-day stopgap bill to avert a government shutdown, in order to give negotiators more time to strike a deal. ACG spent this week making a final push for Congress to:

Prevent looming cuts to GI services: Medicare physician payments are scheduled to be cut across most specialties in CY 2021 when increases to evaluation and management (E/M) services are implemented. GI procedures are scheduled to be cut roughly 10%. However, there’s been significant progress on Capitol Hill. Sen. John Boozman (R-AR) last week introduced the Senate counterpart of the “Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020” (S. 5007/H.R. 8702). This bill delays these Medicare cuts for 2 years, maintains the scheduled reimbursement increases to E/M services, and allows more time for a permanent resolution. Reps. Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN) introduced the House version.

Pass the Removing Barriers to Colorectal Cancer Screening Act: Last week, the U.S. House passed an amended version of H.R. 1570, the Removing Barriers to Colorectal Cancer Screening Act. Passing this bill has been among the top ACG policy priorities for years. ACG has spent this week urging Senators to pass the bill. ACG thanks Rep. Donald Payne, Jr. (D-NJ) and colleagues for their tireless efforts in getting the bill passed through the U.S. House.

Help GI practices with more COVID-19 relief: ACG continues to urge Congress to help GI practices weather the COVID-19 storm. This includes more financial relief for ACG members and improvements to the Provider Relief Fund and Payment Protection Program (PPP). This week ACG also joined 700 organizations on a letter calling for Congress to pass legislation ensuring that expenses associated with PPP loan forgiveness are tax deductible. ACG President David A. Greenwald, MD, FACG also recently conveyed support for the Medicare Sequester COVID Moratorium Act (H.R. 8840). Congressional action is required to extend a moratorium on looming Medicare reimbursement sequestration cuts, which are scheduled to return January 1, 2021.

Pass a fair agreement on “surprise billing”: Late last week, Congressional leaders came to a tentative agreement on “surprise billing,” or when patients are forced to pay the balance of bills for out-of-network care. Among the issues ACG has advocated for are affordable care and access to GI services, fair payments to providers when treating out-of-network patients, an equitable payment dispute resolution process, and mitigating insurer incentives to narrow their networks during contract negotiations with ACG members and instead decide simply to pay providers a legislatively-mandated lower out-of-network reimbursement rate. The details of the agreement are still subject to change. The American Medical Association (AMA) came out in opposition to the agreement this week, alleging Congress is siding with health insurers. Yet, the trade association representing health insurers also came out in opposition to the agreement, alleging that the agreement is too vague, and the dispute resolution process will increase health care costs.

HHS Dispersing More Provider Relief Funds: On Wednesday, the U.S. Department of Health and Human Services (HHS) announced it has reviewed the Phase 3 applications from the Provider Relief Fund (PRF) program and will distribute $24.5 billion to over 70,000 providers. Up from the $20 billion originally planned, the addition of another $4.5 billion in funding is being used to satisfy close to 90% of each applicant’s reported lost revenues and net change in expenses in the first half of 2020. Payments to Phase 3 applicants began on Wednesday. After recipients attest to the terms and conditions for funding, they will be listed in the PRF public dataset. Read the press release here.