ACG Members: We Need Your Advocacy Voice!
From ACG Legislative and Public Policy Council Chair, Whitfield L. Knapple, MD, FACG
We need your help in advocating for two important bills making their way through Congress. Please contact your leaders in Washington D.C. and urge them to support S. 3230, the TA Support Act as well as H.R. 3107, the Improving Seniors' Timely Access to Care Act.
S. 3230 aims to better assist solo and small practices navigate through Medicare reimbursement reporting requirements under the Merit-based Incentive Payment System (MIPS). Currently, HHS provides for MIPS technical assistance funding to assist small practices and practitioners in a professional shortage area. However, funding will end this year. S. 3230 will extend this funding through 2025. Data from the Centers for Medicare & Medicaid Services (CMS) continues to show that solo and small physician practices are more vulnerable to Medicare reimbursement cuts compared to larger physician practices. This is due in part to the complexity of MIPS and the annual regulatory changes. We must do more to help our solo and small practices in designated professional shortage areas across the country.
H.R. 3107 requires improvements to the Medicare Advantage prior authorization process, including real-time decision-making via electronic means for routinely-approved items and services. In addition, the bill establishes patient protections and standards for prior authorization, with adherence to clinical guidelines and other quality criteria. Prior authorizations continue to impact patient care and GI practices. A September 2018 U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) review of Medicare Advantage denials in 2014-2016 reinforces the point that prior authorization requirements prevent patients from receiving medically necessary care. According to the OIG, Medicare Advantage Organizations overturned 75 percent of their own denials during 2014-16, overturning approximately 216,000 denials each year. During the same period, independent reviewers at higher levels of the appeals process overturned even more denials in favor of beneficiaries and providers.
Tell Congress to support these important bills!
Remember to contact your ACG Governor on important state and local issues impacting you and your practice.
The ACG Board of Governors is one of the most unique aspects of the American College of Gastroenterology. Governors are ACG Fellows that are elected from the membership of a particular state or region. There are currently 77 Governors across seven different regions in the U.S. and abroad. The Board of Governors acts as a two-way conduit between College leadership and the membership at-large. This helps the College make certain it is meeting the evolving needs of the membership.
New ACG Practice Management Toolbox Article: Fat(ty) Liver is our Future: Setting Up a Disease Management Program in Your Practice
New this week to the ACG Practice Management Toolbox is an article brought to you by committee members Richard Nemec MD, FACG and Bennie Upchurch, MD, FACG that discusses high quality disease management programs and how to effectively integrate them into your practice and distinguish your practice. Click the link below to read the article.
New ACG Magazine Issue Contains Important Practice Management Toolbox Article
The newest ACG Magazine contains a recently published Practice Management Toolbox article written by Austin Chiang, MD, MPH, David Hass, MD, FACG, and Manoj Mehta, MD, that discusses how to most effectively market your practice in today's digital era. Read the article and listen to the podcast below!
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.