ACG NAAN Advising Congress

From ACG Legislative and Public Policy Council Chair, Louis J. Wilson, MD, FACG

This week James Hobley, MD, MSc, FACG, Christopher South, MD, FACG, and I met with U.S. Representative Brad Wenstrup, D.P.M. (R-OH). We discussed the importance of protecting and supporting ACG members and physicians across the U.S., especially as our nation continues to grapple with another surge in COVID-19. As a physician himself, Rep. Wenstrup understands our frustrations and appreciates the advice from ACG physician advisors. He looks forward to working with the College this year.

Working with Congress, the ACG National Affairs Action Network (NAAN) strives to increase access to care and decrease these burdens unfairly borne by GI practices. ACG will continue to serve as your voice for clinical gastroenterology and our patients.

CMS Vaccine Rule – Different Compliance Timelines for Different States

On January 13, 2022, the U.S. Supreme Court ruled on two cases related to federal COVID-19 vaccination mandates. In one ruling, the Supreme Court struck down a rule requiring workplaces with 100 or more employees to adopt "vaccine-or-test" requirements. In the other case, the Supreme Court permitted the Centers for Medicare & Medicaid Services (CMS) to impose COVID-19 vaccination requirements in virtually all healthcare facilities—with no testing option. The CMS vaccination mandate impacts healthcare workers and facilities receiving funding from Medicare and Medicaid, impacting an estimated 1.7 million workers at 76,000 facilities across the country. Click here for ACG’s summary. This rule was subsequently challenged by various states across the country, ultimately going before the U.S. Supreme Court. While the case was before the court, CMS issued guidance (including facility type-specific guidance) on December 28, 2021 setting forth the plan to proceed with implementation and enforcement requirements in states where the CMS Rule had not been enjoined by court order— which included 25 states, the District of Columbia, and the U.S. Territories.

On January 14, 2022, one day after the U.S. Supreme Court reversed the lower court injunctions, CMS issued additional guidance with a modified timeline for states in the case. The guidance is substantively the same but the compliance dates are different. The scope of "staff" to whom requirements of the rule apply is broadly construed, reaching all who interact with other staff or patients, essentially only carving out those who telework 100% of the time. CMS's definition of "vaccinated" does not require booster shots.

Texas: Please note CMS released updated guidance this week that applies specifically to Texas. According to this guidance, providers are required to meet the Phase 1 criteria by February 21 and Phase 2 by March 21. Full enforcement is effective on April 20, 2022. Texas was subject to an injunction against the CMS Rule, pursuant to a December 15, 2021 order from the U.S. District Court for the Northern District of Texas. However, the case was dismissed this week.

Staffing Shortages: ACG is closely monitoring staffing shortages among GI practices. The U.S. Health and Human Services (HHS) recently released data on hospitals, where at least 18% of hospitals reporting that they were short-staffed as of January 18, 2022. According to Politico, that’s down slightly from the peak about two weeks ago, following the winter holidays. However, other parts of the country have not have hit their peaks.

Weekly Billing and Coding Tip – Common Questions from ACG Members

The ACG Practice Management Committee continues to offer the member-only benefit, the ACG "Billing and Coding Forum." The Forum gives ACG members access to coding expert Arlene Morrow, CPC, CMM, CMSCS. The ACG Practice Management Committee's mission is to bring practicing colleagues together overcome management challenges, to improve operations, enhance productivity, and support physician leadership.

Latest Guidance: Below, please find some coding guidance on recent changes to split/shared E/M services and critical care services for CY 2022.