ACG Public Policy Council Addresses Congressional Doctors Caucus

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

I recently had the privilege to join the congressional "Doctors Caucus" meeting while in Washington, D.C. for the 2022 ACG Advocacy Day. I was honored that my U.S. Representative, Ronny Jackson, MD (R-TX) invited me to speak to this group of physician members of Congress. I discussed the harmful impact that prior authorization has on our patients and practices.

I also emphasized the need for Medicare reimbursement reform, as the effects of inflation and staff shortages continue to strain independent GI practices across the country. Medicare reimbursement cuts only exacerbate these problems. Congress simply must do better to promote competition and ensure access to care.

The Doctors Caucus are key-thought leaders, providing guidance to many in Congress on Medicare reimbursement and coverage issues, as well as other legislative ideas designed to lower health care costs. I left this meeting very encouraged that our physician members of Congress understand the gravity of our situation and was grateful for the opportunity to join this group during my time in D.C. I hope to speak to the group again soon!

I urge my ACG colleagues to get involved with your elected officials. I began by attending local events. We often underestimate the influence we can have on health care policy in our communities and in Washington D.C. There will be many town hall meetings and local events in your areas heading into summer and fall. The ACG NAAN can help prepare you with talking points and advocacy materials. I urge you to get involved today!

Dr. Louis Wilson participating in the Congressional Doctors Caucus meeting in Washington, D.C. Photo from left to right: Representative Drew Ferguson, MDM (R-GA), ACG Legislative and Public Policy Council Chair, Louis Wilson, MD, FACG, and Representative Ronny Jackson, MD (R-TX).

U.S. Department of Justice Targets Practice's PPP Loans in Stark Law Investigation

Other Important Notables for ACG Members:

U.S. Department of Justice Targets PPP Loans: On April 12, 2022, Physician Partners of America (PPOA) agreed to pay $24.5 million to settle False Claims Act (FCA) allegations of violating the Stark Law. In an interesting development, the Department of Justice (DOJ) also alleged that PPOA falsely represented to the Small Business Administration (SBA) when applying for a federal Paycheck Protection Program (PPP) loan. The settlement marks the first documented instance the DOJ has utilized violations of health care laws as the basis to claw back PPP funds. Read this summary of the case prepared by ACG’s health policy consultant, Alston & Bird.

HHS Provides Guidance on Public Health Emergency: HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks-LaSure sent a letter this week to U.S. governors reiterating that HHS would provide 60-day notice before ending the public health emergency (PHE) but provided no timeframe for when the PHE will end. This is important because there are Medicare reimbursement and telehealth policies that are tied to the PHE. Of note, the deadline for the 60-day notice is next week.

CDC Study Suggests 60% of Adults had COVID-19:recent study from the U.S. Centers for Disease Control and Prevention (CDC) suggests that over half of U.S. has had COVID-19, based on blood samples from September 2021–February 2022. According to the CDC research, nearly 60% of Americans have had COVID-19, including 75% of children.

Study on Private Equity Penetration & GI: A recent JAMA study examined the geographic variations in private equity penetration of U.S. physician practices across 6 specialties: dermatology, gastroenterology, ophthalmology, obstetrics/ gynecology, orthopedics, and urology. The study found that nearly 8% of GI practices were acquired by private equity by 2019.

Considering Private Equity? In a recent ACG Virtual Grand Rounds webinar, Dr. Vonda G. Reeves and Dr. Stephen T. Amann provided some "lessons learned" and well as guidance for ACG members considering the private equity model. These tips also include issues to consider depending on the stage of your career. Click here for the webinar.

Big Changes to E/M Split Services in 2023: Are You Prepared?

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

Absent any changes in the forthcoming Medicare payment rules, beginning next year, only the physician or qualified health professional who performs more than 50% of the total visit time can bill for a split/shared visit. ACG is working with the GI societies and a coalition of organizations urging CMS not to finalize this policy, which could significantly impact ACG members and GI practices. What are the changes impacting your services and reimbursement? What changes do your billing managers and coders need to know?

The ACG Practice Management Committee offers professional coding and documentation assistance for ACG members, tailored to your individual practice’s questions and needs.  ACG Coding & Billing Forum and Arlene Morrow, CPC, CMM, CMSCS walk through the background and important changes for you.

Take advantage of this ACG member-benefit today so your practice is prepared tomorrow! Click here to review Ms. Morrow's recent presentation during the April 2022 ACG Board of Governors Meeting.