The AGA and almost the entire medical community opposed the passage of H.R. 4302, 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.
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| Dr. John I. Allen |
The AGA is extremely disappointed that Congress passed a Sustainable Growth Rate patch because this was the closest we have been to enacting a permanent solution to the SGR. This action jeopardizes the chances of Congress enacting a long-term solution this year, and also continues to put specialties like gastroenterology in jeopardy by expanding the Centers for Medicare & Medicaid Services' existing authority to identify misvalued codes. Since GI has already been resurveyed by the CMS for both upper and lower procedures, we remain concerned that nothing in this legislation protects us from being targeted again by the agency since the CMS needs to come up with savings associated with this section.
For some specialties like gastroenterology, this "freeze" amounts to a cut in payments when factored with the 2% across-the-board Medicare sequestration cut and recent CMS cuts to GI services. The misvalued codes provision, which basically "doubles down" the administration's existing authority, will put more pressure on the agency to find savings. Given this increased authority, the AGA, ACG, and ASGE continue to call on Congress to sign on to the "Dear Colleague" letter being circulated by Rep. Bill Cassidy (R-La.) asking for more transparency in how they determine relative values. The need for greater transparency and the need for physicians to be able to meaningfully comment on significant changes to their practices will be imperative given the pressure that the CMS will be under to find savings from physician services.
The AGA and the entire GI community will continue to advocate on behalf of gastroenterology to ensure that it is adequately compensated, commensurate with the value that we provide to patients with digestive diseases.
Dr. John I. Allen, AGAF, M.B.A., is professor of medicine and clinical chief of digestive diseases at Yale University School of Medicine, New Haven, Conn.
