ACG and the DDNC: Advocating on Behalf of You and Your Patients

From ACG Vice President and DDNC President, Samir Shah, MD, FACG

On Wednesday, November 13th, ACG joined the Digestive Disease National Coalition and 18 other patient advocacy groups on Capitol Hill to advocate for the passage of the Safe Step Act (H.R. 2279, S. 2546). This bill aims to restrict step therapy requirements and assists patients who require quicker access to the drugs or therapies they need to treat their conditions--instead of being forced to take the step of failing cheaper medication first. The House version of the bill was introduced in April of 2019 and currently has 110 cosponsors on a bipartisan basis. The Senate version was recently introduced in September of 2019, and is currently gaining momentum. Thanks to the DDNC for organizing this important day of advocacy. ACG will continue to partner with patient advocates to improve access to GI health care.

Urge your Representatives and Senators to pass the Safe Step Act now!

Massachusetts – Tell Your Member to Pass Step Therapy Legislation!

From ACG Massachusetts Governor Anthony Lembo, MD, FACG

Massachusetts members--your state has their own version of an important step therapy bill. ACG is working with patient advocates at the state level too. Tell your state legislators to pass SD 2096/HD 1506 now!

HHS Releases Price Transparency Rules for Insurers and Hospitals

From ACG Legislative and Public Policy Council Chair, Whitfield L. Knapple, MD, FACG

On Friday, November 15th, the U.S. Department of Health and Human Services (HHS) released two rules designed to make hospitals and insurance price contracts more transparent for patients.

One proposed rule requires health plans participating in exchanges regulated by the ACA, and employer-sponsored insurance markets covered under ERISA, to disclose negotiated rates with providers in their networks. Insurers will also have to disclose charges for out-of-network care. HHS is also requiring insurers to develop an online tool, in order to show out-of-pocket costs in real time.The goal is to make it easier for people to compare the costs among providers and health services.

Click here for the rule and factsheet.

The Trump Administration also released the final rule for hospitals (proposed in July). Effective January 2021, facilities would have to disclose negotiated rates with insurers. Hospitals will also have to disclose what they are willing to accept in cash payments. Hospitals will have to post information online for 300 common services in an easily understandable format. HHS will specify 70 of these services, and hospitals can choose the rest. Colonoscopy is one such service highlighted in the final rule. Hospitals that don’t comply could face fines of up to $300 per day.

One important note for ACG members: ASCs are not covered under this regulation impacting hospitals.

Among the list of these 70 required services: new patient E/M services (CPT codes 99203-99205), patient consultations (CPT codes 99243, 99244), new patient preventive medicine evaluations (CPT codes 99385 and 99386), EGD (CPT code 43235), EGD with biopsy (CPT code 43239), diagnostic colonoscopy (CPT code 45378), colonoscopy with biopsy (CPT code 45380), colonoscopy with lesion removal (CPT code 45385), and colonoscopy with EUS (CPT code 45391).

Click here to read to the rule and factsheet.

ACG is still culling these rules released on Friday afternoon and will provide an update on the impact to GI services and ACG members.

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.

ACG Board of Governors Chair Neil Stollman, MD, FACG

ACG Board of Governors Vice Chair Patrick Young, MD, FACG

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.

The Toolbox is a series of short articles, written by practicing gastroenterologists, that provide members with easily accessible information to improve their practices. Each article covers an issue important to private practice gastroenterologists and physician-lead clinical practices.