Looming Medicare Cuts: ACG Continues to Make Progress on Capitol Hill

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

Thank You ACG Members: ACG recently urged members to advocate for a U.S. House letter urging Congressional action to address looming Medicare cuts in any upcoming legislation moving through the House. There were 229 total signatures on the letter, thanks to your advocacy!

Medicare physician payments are scheduled to be cut across most specialties in 2021 in part due to increases to evaluation and management (E/M) services. Various Medicare physician payments are scheduled to be cut across most specialties in 2021 in part due to increases to evaluation and management (E/M) services. Individual U.S. Senators have now started to request action to address this issue as well. Sen. Susan Collins (R-ME) recently urged Senate Leadership to help prevent these looming cuts and waive budget-neutrality rules.

More than just E/M changes are impacting cuts to procedural services: According to the American Medical Association, the increases to E/M services make up roughly one-half of these projected cuts to other services due to budget-neutrality rules. ACG supports changes to E/M services but continues to stress the importance of preventing these cuts to other GI services and endoscopy. CMS and Congress must consider waiving budget-neutrality rules in order to maintain access to important GI procedures and services. Medicare reimbursement for GI procedures are scheduled to be cut by an estimated 10%.

ACG on Capitol Hill this week educating lawmakers and staff: ACG continues to advocate Congress on your behalf. A new October 2020 update on health care services demonstrates that while some specialties are close to returning to pre-pandemic levels, gastroenterology is still down by an estimated -5%. This is concerning, as studies continue to mount on COVID-19’s impact to patient care, colorectal cancer screening, and missed diagnoses. A recent study found that a drop in cancer diagnoses was attributed to COVID-19 and the delay in screening, including colorectal cancer screening. Another study found that screenings for breast, cervical, and colon cancer dropped by an estimated 90% after the declaration of the COVID-19 national emergency. While the number of cancer screenings has recently begun to rise, however, a follow-up study concluded that the expected levels of screenings are still down by one-third.

Earlier this year, GI practices were forced to shut down, furlough staff, and delay necessary care. At a time when GI practices are trying to treat patients and bracing for a potential second wave of shutdowns, proposed cuts to these very services only exasperates the problem.

Good news: Rep. Michael Burgess, MD (R-TX) has introduced a bill (H.R. 8505) that waives budget-neutrality rules for one year, preventing these cuts from being implemented by offsetting the costs with leftover Provider Relief Fund money. As you know, this program was part of the CARES Act passed in the spring of 2020.

Personal Note: It has been an honor to serve as Chair of the ACG Legislative and Public Policy Council. The Council was formed by the ACG Board of Trustees to work with the ACG Board of Governors and related ACG committees to align and establish the public policy priorities for the College. I want to thank members of the Council for their service and helping to meet these goals. The incoming Chair, James Hobley, MD, FACG has been very active in the College and will be an outstanding leader. ACG members will be in good hands under the stewardship of Dr. Hobley.

The ACG Legislative Action Center is often referenced in these weekly updates, providing a user-friendly way to contact our elected officials at the state and federal level. It is my hope that the ACG Legislative Action Center continues to grow and that thousands of ACG members take advantage of this platform to advocate for our patients and practices.

Thank you again for the opportunity to lead the ACG Public Policy Council.

Welcome new ACG Legislative and Public Policy Council Chair, James Hobley, MD, FACG

What is the Practice Management Toolbox?

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. They include a brief introduction, a topic overview, specific suggestions, helpful examples and a list of resources or references. Each month a new edition of the Toolbox will be released and will then remain available here along with all previous editions. The Practice Management Committee is confident this series will a provide valuable resource for members striving to optimize their practices.

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