AGA Washington Insider

A policy blog for GIs

AGA Continues to Call for More Transparency at CMS

Dr Rustgi with CassidySince the release of the cuts in upper GI endoscopy services in the Medicare Physician Fee Schedule Final Rule last November, AGA and our sister societies have been fighting a two-pronged advocacy campaign on behalf of gastroenterology. While the GI societies have been meeting with CMS to get a better understanding of the methodology that was used to cut these rates, we have also been on Capitol Hill literally every day to solicit Congress’ oversight authority to ask CMS for better transparency when making decisions that impact physician practices and their patients.

The GI societies have been working closely with Rep. Bill Cassidy, R-LA (left with AGA Institute President Anil Rustgi, MD, AGAF), a hepatologist, who is circulating a letter to CMS asking that they publish any changes to physician values in the proposed rule to allow physicians the opportunity to participate in the regulatory process and provide meaningful comments. Unfortunately for gastroenterology, we were not afforded that ability for upper GI endoscopy services since CMS published the changes in the final rule, giving us less than four weeks to analyze the changes and for practices to prepare for the cuts, which went into effect on Jan. 1, 2014.

We’re Being Heard

Since starting this advocacy initiative, we have been able to secure the support of other physician societies for our efforts, such as cardiology, neurology, rheumatology, neurological surgeons, spine specialists, osteopaths and several other groups. Given the groundswell of support this initiative has received, and given the need for more transparency, the ranking Democratic members of the House Ways and Means and Energy and Commerce Committees recently sent a letter to CMS asking the agency to provide physicians with the opportunity to comment on proposed changes and to include these changes in the proposed rule. We appreciate Reps. Levin, McDermott, Waxman and Pallone weighing in on this important issue, especially since colonoscopy is currently being reviewed and we want to be able to properly weigh in on potential changes to this lifesaving procedure.

We Need Your Help

Rep. Cassidy is still soliciting support for his letter and AGA is still reaching out to members of Congress to encourage them to sign before the April 11 deadline. We appreciate all of the AGA members who have taken time to contact their representatives on this critical transparency issue. If you haven’t already, please take a moment to contact your representative and ask them to sign the Cassidy letter to CMS. We believe transparency is even more critical now that Congress enacted a patch for the sustainable growth rate formula that expands CMS’ authority over identifying “misvalued codes” and puts more pressure on the agency to find savings in physician services.

We will continue to push this issue. The squeaky wheel is getting the oil since our voices are being heard.

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