ACG Calls on Congress to Prevent Reimbursement Cuts

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

ACG Part of Coalition Saying No to Medicare Sequestration Cuts

ACG joined 50 health care organizations urging Congress to extend the 2% Medicare sequester moratorium until the end of the COVID-19 public health emergency. As you know, in December 2021, Congress authorized a 3 month delay of Medicare payment cuts of 2% (January 1, 2022 - March 31, 2022), but a 1% payment cut looms in April, all while GI practices are still facing onerous regulatory burdens, increasing costs, and staffing shortages.

ACG will be doing our part to make sure Congress recognizes the critical role ACG members have played during this public health emergency. Especially at a time when our nation faces a backlog of delayed colorectal cancer screenings. Congress must do better. ACG will continue to represent GI clinicians on Capitol Hill.

White House proclamation promotes CRC screening: This week, President Biden officially declared the month of March, "National Colorectal Cancer Awareness Month," in a proclamation released February 28th. The proclamation emphasized that colorectal cancer can affect anyone, but regular screenings are important to saving lives.

ACG has important patient resources on colorectal cancer, symptoms, and risk factors for you and your patients. They include an infographic, "rack cards" to download or print, flyers, and social media banners for your use. Click on the banner below to download!

United Healthcare Makes Prior Authorization Announcements

From ACG Practice Management Committee Chair, Stephen T. Amann, MD, FACG

Important Changes Effective May 2022

United Healthcare (UCH) recently announced that its Prescription Drug List (PDL) Management Committee decided that effective May 1, 2022, Trulance (plecanatide) will no longer be covered under its pharmacy benefit. Linzess (linaclotide) and Motegrity (prucalopride) will remain covered with prior authorization.

United Healthcare Halts Paper Prior Authorization and Appeal Decision Letters

United Healthcare announced that it will soon discontinue mailing paper appeal decision, prior authorization, and clinical decision letters. Providers will instead be directed to access this correspondence electronically through "Document Library," UHC’s online repository of claim-related communication and reports. More details are available here.

Key dates:
Beginning March 4, 2022, UHC will discontinue mailing appeal decision letters for its Medicare Advantage and commercial plans, excluding UHC West plans.

Beginning April 1, 2022, UHC will no longer mail prior authorization and clinical decision letters, including letters requesting additional information, approvals, and denials.

ACG Prior Authorization Survey: Click here for the ACG Prior Authorization Advocacy One-Pager. Please share and help bring attention to these dangerous trends limiting access to care and impinging the patient-physician relationship. Prior authorization is harming patients and GI practices!

Patient Stories Showing Harm and Adverse Events from Prior Authorization: Please encourage your patients to contact ACG about their experiences with prior authorization and the impact to their care. ACG is collating these stories for meetings with legislators and hopes to bring the power of patient voices to these discussions.

Latest Edition of ACG MAGAZINE: The ACG & DDNC Partnership and New Practice Management Toolbox Article