AGA Washington Insider

A policy blog for GIs

AGA Opposes House-Approved One Year SGR Patch, But Pleased About Potential Delay of ICD-10

The House approved H.R. 4302, legislation that would provide a one year freeze in Medicare physician payments and prevent the 24 percent cut from being implemented on April 1. The legislation, which is opposed by the AGA and almost the entire medical community, passed the House by voice vote and now heads to the Senate. The AGA opposes this temporary patch since it does nothing to fix the underlying problem with the Medicare physician payment system — it’s a temporary solution that finances the fix on the backs of specialty medicine.

The AGA is extremely disappointed that the House passed a patch since we were so close to finally enacting a permanent solution to the sustainable growth rate formula (SGR). This action not only jeopardizes a long-term solution, but also fractures unity in the physician community by picking winners and losers. Unfortunately, GI came out on the losing end of this, which will be bad for the millions of patients with digestive diseases.

However, AGA is pleased that the House has voted to temporarily delay the switch from ICD-9 to the ICD-10 coding system until Oct. 1, 2015. This legislation still needs approval in the Senate.

Why AGA Opposes It
The SGR patch legislation would finance the freeze by extending the misvalued codes initiative, under which CMS has the authority to identify and reevaluate misvalued codes. Gastroenterology has experienced this process: the three families of upper GI codes were resurveyed and subsequently cut by 12 percent. CMS failed to publish these changes until four weeks before they were to be implemented on Jan. 1. Colonoscopy has recently undergone this process and we will see changes to the reimbursement values of colonoscopy in the 2015 Medicare Physician Fee Schedule.

CMS has not been transparent in its process and continues to have unprecedented authority to make changes to codes that they deem overvalued and are specifically targeting specialty physicians. This provision will only make matters worse. At a time when the entire physician community came together to support a viable long-term solution to the SGR (S. 2000/H.R. 4015), this policy fractures that unity.

The Republican leadership was uncertain whether or not they would bring the bill to the floor for a vote since there was mounting opposition to the legislation. However, given the Senate’s inability to pass a long term SGR bill, the House leadership felt as though they needed to quickly bring a bill to vote that would prevent the 24 percent cut. In fact, the House leadership — both Republican and Democrats — brought the bill to the floor under suspension of the rules that requires a 2/3 vote. The majority of members were not even present for the vote and the leadership rushed the bill through for passage.

What Does This Mean for GI?
For some specialties like gastroenterology, this “freeze” amounts to a cut in payments when factored with the 2 percent across the board Medicare sequestration cut and recent CMS cuts to GI services. The misvalued codes provision, which basically “double downs” the administration’s existing authority, will put more pressure on the agency to find savings from codes that are high volume.

What Happened to the SGR Fix Legislation?
The new Senate Finance Chair Ron Wyden, D-OR, has been pushing legislation that was agreed to by all of the authorizing committees, both parties, both congressional chambers and the entire physician community that would repeal the SGR and transition physicians to a more value-based payment system. However, the major hurdle has been how to pay for a permanent fix. The House passed a permanent fix, but paid for it by delaying the individual mandate. Chairman Wyden proposes to pay for it by using the overseas contingency operations funds, which would have been used for the wars in Iraq and Afghanistan. Republicans oppose using these funds, which they call a gimmick. It is unsure whether the Senate will bring up Chairman Wyden’s proposal.

51 Comments

  1. Today, I went to the beachfront with my children.
    I found a sea shell and gave it to my 4 year old daughter and said “You can hear the ocean if you put this to your ear.” She
    placed the shell to her ear and screamed. There was a
    hermit crab inside and it pinched her ear. She never wants to go back!
    LoL I know this is totally off topic but I had to tell someone!

  2. Video game store associates tend to become pretty heavy players in their very own right, so
    they really know some concepts you can try out. Continue towards the second page for a
    breakdown of most seven game maps. Ibuypower chimera There is nothing more fun than playing a sports game using your buddies on local co-op and even playing one particular
    player campaign with one of one’s friends.

    Their laptops are referred to as standing out in the crowd thanks
    to their excellent aesthetic design and extreme performance.
    It’s an adventure game, as well as the focus is that you simply (or even the characters you play, being more accurate).

  3. However, should your home is not equipped with one a tough estimate from
    Bell Inspection in Florida advises that this cost could run you from $300 to
    $500 per circuit. You can apply a “sweeping” motion, wherein you
    direct water from the house going outward, making sure how the pressure remains constant every one of the way.

    Whirlpool duet washing machine manual You will want a stackable dryer and washing machine set that fits the needs
    of one’s family, contains features you would like, and meets
    space constraints.

    Long sweeping though, should be used only if there are no
    obstructions throughout the length of the deck, as these can cause lines which is going to be difficult to remove
    later on. This will assist you to flexibility to dry
    literally any type of fabric without concern yourself with damaging the integrity from the fabric.

  4. Yes! Finally something about lamar odom drugged rob kardashian accused.

  5. I do not know if it’s just me or if perhaps everybody else encountering problems with
    your website. It looks like some of the written text on your content are running off the screen. Can somebody else please comment
    and let me know if this is happening to them too? This may
    be a problem with my browser because I’ve had this happen before.

    Cheers

  6. Nevertheless, if you happen to be hunting for a enjoyable game to
    play by oneself or with family members members
    which encourages creativity and imagination, Minecraft is definitely the way to go.
    Copyright © 2014 Minecraft for Play Station three DOWNLOAD (SIZE:
    372.81 MB) – You can download here Minecraft for PS3 console.

  7. In the present scenario animation has a huge demand in national as well as in international market.
    The best part of the weekend growing up was rushing to
    the television and seeing what the cartoons were and where they would take
    me. The new logo is only the two initials C and N in black and white colors.

  8. Hi my family member! I want to say that this post is
    amazing, nice written and include almost all vital infos.

    I’d like to peer more posts like this .

  9. 11 and found that new files have been added that disclose new information about GTA Online and its online heists game mode.

    Although you certainly do have many different options available to you as to how to reach your customers, one of
    the easiest things that you can do is to use an online marketplace that is
    already established. The whole procedure is
    same while one recharges with other service providers too like Aortal, BSNL,
    MTNL, MTS, Idea, Reliance or any other.

  10. Pretty nice post. I simply stumbled upon your blog and wished to
    say that I’ve truly loved surfing around your weblog posts.

    In any case I’ll be subscribing in your feed and I hope you write once
    more soon!

  11. The viral relatives tree confirmed that HSV-2 was a lot more genetically like the herpes virus within chimpanzees.

  12. I am now not positive the place you’re getting your information, but great topic.

    I needs to spend a while learning more or understanding more.
    Thanks for magnifiicent information I used tto be searching for this info for my mission.

  13. Then there are automotive nuts, which are available as simple nuts, collar nuts, locking nuts, t-nuts, hex nuts, jam nuts, lug nuts, plate nuts, self locking nuts, stainless steel nuts etc.
    Hence, if you can get associated with a glass company that shares good relationship with
    the insurance company, then it will be convenient for you to get the recovery for your damage.
    Whenever you shift from “park” to “drive” or from “drive” to “neutral” or even “reverse”
    your transmission should immediately respond by engaging smoothly without delay, with no jerking and no unexpected noises.

  14. There electric company are many electricians that you distribute can be
    very expensive, and extremely risky for those of us on a budget.
    By comparing rates and the services included, you will have to pay the rent of compensation if the fire alarms were not installed or other security features that are missing.
    Professional companies make sure to browse down through the offers.
    Whether you decide to purchase one outright.

  15. Hi! I know this is kinda off topic however I’d figured I’d ask.

    Would you be interested in exchanging links or maybe guest authoring a blog article or vice-versa?
    My website addresses a lot of the same subjects as yours
    and I feel we could greatly benefit from each other. If
    you’re interested feel free to send me an e-mail. I look forward to hearing from you!
    Wonderful blog by the way!

  16. Hi! Do you know if they make any plugins to help
    with Search Engine Optimization? I’m trying to get my blog to rank for some targeted
    keywords but I’m not seeing very good gains. If you know of any
    please share. Appreciate it!

  17. Hello, after reading this remarkable article i am too glad to share my knowledge here with mates.

  18. My family always say that I am wasting my time here at web,
    but I know I am getting knowledge all the time by reading such fastidious articles
    or reviews.

  19. An outstanding share! I have just forwarded this onto a coworker who has been conducting a
    little homework on this. And he in fact bought me dinner because
    I discovered it for him… lol. So let me reword
    this…. Thanks for the meal!! But yeah, thanx for spending
    time to discuss this matter here on your web site.

  20. Wow! In the end I got a webpage from where I be capable of actually take helpful facts concerning my study and
    knowledge.

  21. We stumbled over here different web address and thought I might check things out.
    I like what I see so now i’m following you. Look forward to finding out about your web page for a second time.

  22. I’m a developer and I have just thought of a groundbreaking online social network webpage.

    I am only in need of ‘beta’ testers to search and give
    it a shot. Are you looking to opt-in? We’re going to pay you.

  23. I was curious if you ever considered changing the page layout of your website?

    Its very well written; I love what youve got to say.

    But maybe you could a little more in the way of content so people could connect with it better.
    Youve got an awful lot of text for only having one or two pictures.
    Maybe you could space it out better?

  24. With that, gamers should know that the longer video (presumably) characteristics a large chunk of
    the game.

  25. Pics, Mallu Solely Co. Horny Images girls again best
    I photos, Mattress for your Mallu the chlor-trimeton saree
    Again to Hot Hot ups Labels: Mallu Mallu upsypes xHamster.

  26. What a information of un-ambiguity and preserveness of precious knowledge
    regarding unexpected emotions.

  27. If you desire to take much from this paragraph then you have
    to apply these methods to your won webpage.

  28. Each year Hindus across the world religiously
    fast for nine days twice in the year. They step to it
    all is unquestionably what consume, and in case you do some regular, modest workouts that can bring faster results and make you
    feel better in the long run. Opskrifter pa 5 2 kuren Any diet that controls your level of calories for the point of fatigue, hunger, and lethargy is not
    empowering your body but instead tearing it down.

    It’s the delicious shakes that made the diet plan famous, there
    is however much more to this healthy eating plan. So yeah, I’m not claiming
    to own discovered the “new internet” ;) but in terms of impacting my entire life, this company has produced dieting a great deal
    easier.

  29. Hmm it seems like your website ate my first comment (it
    was extremely long) so I guess I’ll just sum it up what I wrote and
    say, I’m thoroughly enjoying your blog. I as well am an aspiring blog
    blogger but I’m still new to the whole thing.
    Do you have any suggestions for first-time blog writers?

    I’d genuinely appreciate it.

  30. Good post however I was wanting to know if you could write a litte more on this topic?
    I’d be very thankful if you could elaborate a little bit
    more. Thank you!

  31. Great blog! Do you have any helpful hints for aspiring writers?
    I’m hoping to start my own site soon but I’m a
    little lost on everything. Would you advise starting with a free platform like WordPress or go for a
    paid option? There are so many choices out there that I’m completely confused ..
    Any recommendations? Appreciate it!

  32. دانلود فیلم,دانلود فیلم,دانلود فیلم,دانلود فیلم,دانلود فیلم,دانلود فیلم,دانلود فیلم,

  33. And to lose weight fast and effectively four aspects of life should be changed:
    what to eat, how to eat, behavior and activity level.

    You can also combine different forms of cardiovascular exercises to keep
    yourself away from boredom. A convenient and effective way to lose weight and undertake a
    complete strength-training workout of all your major muscle groups is to use a resistance tube.

  34. Thanks for sharing your thoughts on Tangerang Dgital Agency.
    Regards

  35. We are a gaggle of volunteers and opening a new scheme in our community.
    Your web site provided us with helpful information to work on. You have
    performed a formidable activity and our entire community might be grateful to you.

  36. Earlier within the year senior Conservative figures promised help for solar energy
    on schools when Minsters for Training and Vitality – Michael Gove and Greg Barker – posed for pictures on a solar roof in London.

  37. This paragraph will assist the internet visitors for setting up new web site or
    even a blog from start to end.

  38. I am curious to find out what blog platform you’re using?

    I’m having some small security problems with my latest website and I would
    like to find something more safeguarded. Do you have any recommendations?

  39. What’s up, the whole thing is going sound here and ofcourse every one is sharing data,
    that’s actually fine, keep up writing.

  40. An interesting discussion is definitely worth comment. I
    do believe that you ought to publish more on this topic, it might not be a taboo matter but usually people don’t
    discuss such subjects. To the next! Best wishes!!

  41. Appreciation to my father who informed me concerning this blog, this webpage is truly remarkable.

  42. Engineering Improved and with it Came Awesome Math Game titles.
    There are many games that can be highly addictive, such as fighting games or sports games.
    If your gaming console is not working, you will need
    to decide if you will buy a new one or have
    it repaired.

  43. If some one wishes to be updated with newest technologies after that he must be pay a quick visit this site and be up to date every day.

  44. Great goods from you, man. I have have in mind your stuff prior to and you are simply extremely magnificent.
    I really like what you’ve acquired right here, certainly like what you are saying and the best way by which you assert it.

    You’re making it entertaining and you continue to
    care for to stay it sensible. I can’t wait to learn far more from you.
    That is actually a terrific web site.

  45. I love what you guys are usually up too.
    This sort of clever work and coverage! Keep up the excellent works guys I’ve added you guys to our
    blogroll.

  46. Hello there! This article couldn’t be written much
    better! Reading through this post reminds me of my previous roommate!
    He always kept talking about this. I am going to send this information to him.
    Pretty sure he’ll have a good read. Thank you for sharing!

  47. It’s awesome to visit this web site and reading the views of all friends on the topic of this paragraph, while I am also keen of getting experience.

  48. Fabulous, what a webpage it is! This website provides helpful data to us, keep it
    up.

  49. Like Twain, Melville’s character Queequeg is critical of some of
    the darker effects of missionary influence on island life.
    Hunger to watch television now a space lacking a television. The emulator is available and the integrated environment is Eclipse.

  50. you’re in reality a excellent webmaster. The website loading velocity is incredible.
    It seems that you are doing any unique trick. Moreover, The contents are masterpiece.
    you have performed a fantastic process in this matter!

Leave a Response