News from the AGA

Dear colleagues,

I have the privilege and honor to serve as AGA president as of June 1, 2020. When we look back at the first half of 2020, we will remember the COVID-19 pandemic and the unimaginable loss of life, morbidity, and economic impact it had. We will also remember the grief and anger that have characterized the recent weeks. I hope that the second half of 2020 will be a time that reshapes us for the better and allows us to seize the opportunity to make meaningful changes, in addition to recovering from the impact of the pandemic. The ongoing protests for the past 16 days against police brutality finally have our country recognizing front-and-center injustices facing African Americans.

While recognition of an injustice is a start, it is essentially meaningless unless action is taken to ensure equity in all facets of society. Of particular interest to AGA is access to health care without bias, addressing racial disparities in health care, diversity within the practice of GI, and supporting the careers of diverse researchers. AGA has a diversity policy and a solid history of programs supporting minority physicians and researchers. We know that’s not enough and AGA, with our dedicated committees, staff, and leadership, will continue to implement and assess plans for meaningful improvements. Watch for more on this topic in the future.

In addition, AGA took a pledge with our GI sister organizations to “continue to advocate for diversity in our staff and governance, grant awards to research health care disparities, ensure quality care for all, and work tirelessly to reduce inequalities in health care delivery and access.” We plan to honor this pledge with our own efforts and by making a concerted effort to work with AASLD, ACG, ASGE, DHPA, and other societies, colleagues, and friends.

The COVID-19 pandemic has been a major challenge for our practices and to our research community. To all AGA members, please know that we have your back with a stream of practice guidance, business support, advocacy, and funding. You can find these resources collected at www.gastro.org/COVID.

My special thanks to the following AGA members, among several AGA staff and expert participants, for making these resources possible and highly engaging:

• Maria Abreu, who oversees our weekly COVID Connection webinar.
• Shahnaz Sultan and Joseph Lim whose Guidelines and Clinical Practice Update committees have generated evidence-based practice guidance at an incredible pace.
• Vivek Kaul and Vijay Shah who lead regular townhall webinars with division chiefs to share how GI divisions are pivoting to address the numerous current challenges.
• Rhonda Souza, chair of AGA Council, which is already thinking about how to make DDW 2021 a success.

Throughout my time as AGA president, I plan to communicate with you on a regular basis and welcome your input and suggestions. Watch the AGA Community for updates and announcements. Every other month, I plan to host a Townhall with the AGA President webinar on Zoom, where we can gather to hear from AGA leaders and staff on their work. My first webinar is planned for July 10, 2020, at 11 a.m. United States Eastern time. Watch for more info to come.

My goals are to build on what past president Hashem El-Serag has initiated and to work closely with John Inadomi (president-elect), John Carethers (vice president), the AGA Governing Board, committees, and staff. Along these lines, we will work tirelessly to support AGA domestic and international members and the gastroenterology community needs, be it patient care and those who provide the care, basic and clinical scientific discovery, education and training, advocacy, and ABIM recertification. I look forward to working with you and for you throughout the year.

Sincerely,
Bishr Omary, MD, PhD, AGAF
AGA Institute President

Dear colleagues,

I have the privilege and honor to serve as AGA president as of June 1, 2020. When we look back at the first half of 2020, we will remember the COVID-19 pandemic and the unimaginable loss of life, morbidity, and economic impact it had. We will also remember the grief and anger that have characterized the recent weeks. I hope that the second half of 2020 will be a time that reshapes us for the better and allows us to seize the opportunity to make meaningful changes, in addition to recovering from the impact of the pandemic. The ongoing protests for the past 16 days against police brutality finally have our country recognizing front-and-center injustices facing African Americans.

While recognition of an injustice is a start, it is essentially meaningless unless action is taken to ensure equity in all facets of society. Of particular interest to AGA is access to health care without bias, addressing racial disparities in health care, diversity within the practice of GI, and supporting the careers of diverse researchers. AGA has a diversity policy and a solid history of programs supporting minority physicians and researchers. We know that’s not enough and AGA, with our dedicated committees, staff, and leadership, will continue to implement and assess plans for meaningful improvements. Watch for more on this topic in the future.

In addition, AGA took a pledge with our GI sister organizations to “continue to advocate for diversity in our staff and governance, grant awards to research health care disparities, ensure quality care for all, and work tirelessly to reduce inequalities in health care delivery and access.” We plan to honor this pledge with our own efforts and by making a concerted effort to work with AASLD, ACG, ASGE, DHPA, and other societies, colleagues, and friends.

The COVID-19 pandemic has been a major challenge for our practices and to our research community. To all AGA members, please know that we have your back with a stream of practice guidance, business support, advocacy, and funding. You can find these resources collected at www.gastro.org/COVID.

My special thanks to the following AGA members, among several AGA staff and expert participants, for making these resources possible and highly engaging:

• Maria Abreu, who oversees our weekly COVID Connection webinar.
• Shahnaz Sultan and Joseph Lim whose Guidelines and Clinical Practice Update committees have generated evidence-based practice guidance at an incredible pace.
• Vivek Kaul and Vijay Shah who lead regular townhall webinars with division chiefs to share how GI divisions are pivoting to address the numerous current challenges.
• Rhonda Souza, chair of AGA Council, which is already thinking about how to make DDW 2021 a success.

Throughout my time as AGA president, I plan to communicate with you on a regular basis and welcome your input and suggestions. Watch the AGA Community for updates and announcements. Every other month, I plan to host a Townhall with the AGA President webinar on Zoom, where we can gather to hear from AGA leaders and staff on their work. My first webinar is planned for July 10, 2020, at 11 a.m. United States Eastern time. Watch for more info to come.

My goals are to build on what past president Hashem El-Serag has initiated and to work closely with John Inadomi (president-elect), John Carethers (vice president), the AGA Governing Board, committees, and staff. Along these lines, we will work tirelessly to support AGA domestic and international members and the gastroenterology community needs, be it patient care and those who provide the care, basic and clinical scientific discovery, education and training, advocacy, and ABIM recertification. I look forward to working with you and for you throughout the year.

Sincerely,
Bishr Omary, MD, PhD, AGAF
AGA Institute President

Dear colleagues,

I have the privilege and honor to serve as AGA president as of June 1, 2020. When we look back at the first half of 2020, we will remember the COVID-19 pandemic and the unimaginable loss of life, morbidity, and economic impact it had. We will also remember the grief and anger that have characterized the recent weeks. I hope that the second half of 2020 will be a time that reshapes us for the better and allows us to seize the opportunity to make meaningful changes, in addition to recovering from the impact of the pandemic. The ongoing protests for the past 16 days against police brutality finally have our country recognizing front-and-center injustices facing African Americans.

While recognition of an injustice is a start, it is essentially meaningless unless action is taken to ensure equity in all facets of society. Of particular interest to AGA is access to health care without bias, addressing racial disparities in health care, diversity within the practice of GI, and supporting the careers of diverse researchers. AGA has a diversity policy and a solid history of programs supporting minority physicians and researchers. We know that’s not enough and AGA, with our dedicated committees, staff, and leadership, will continue to implement and assess plans for meaningful improvements. Watch for more on this topic in the future.

In addition, AGA took a pledge with our GI sister organizations to “continue to advocate for diversity in our staff and governance, grant awards to research health care disparities, ensure quality care for all, and work tirelessly to reduce inequalities in health care delivery and access.” We plan to honor this pledge with our own efforts and by making a concerted effort to work with AASLD, ACG, ASGE, DHPA, and other societies, colleagues, and friends.

The COVID-19 pandemic has been a major challenge for our practices and to our research community. To all AGA members, please know that we have your back with a stream of practice guidance, business support, advocacy, and funding. You can find these resources collected at www.gastro.org/COVID.

My special thanks to the following AGA members, among several AGA staff and expert participants, for making these resources possible and highly engaging:

• Maria Abreu, who oversees our weekly COVID Connection webinar.
• Shahnaz Sultan and Joseph Lim whose Guidelines and Clinical Practice Update committees have generated evidence-based practice guidance at an incredible pace.
• Vivek Kaul and Vijay Shah who lead regular townhall webinars with division chiefs to share how GI divisions are pivoting to address the numerous current challenges.
• Rhonda Souza, chair of AGA Council, which is already thinking about how to make DDW 2021 a success.

Throughout my time as AGA president, I plan to communicate with you on a regular basis and welcome your input and suggestions. Watch the AGA Community for updates and announcements. Every other month, I plan to host a Townhall with the AGA President webinar on Zoom, where we can gather to hear from AGA leaders and staff on their work. My first webinar is planned for July 10, 2020, at 11 a.m. United States Eastern time. Watch for more info to come.

My goals are to build on what past president Hashem El-Serag has initiated and to work closely with John Inadomi (president-elect), John Carethers (vice president), the AGA Governing Board, committees, and staff. Along these lines, we will work tirelessly to support AGA domestic and international members and the gastroenterology community needs, be it patient care and those who provide the care, basic and clinical scientific discovery, education and training, advocacy, and ABIM recertification. I look forward to working with you and for you throughout the year.

Sincerely,
Bishr Omary, MD, PhD, AGAF
AGA Institute President

The AGA Community (https://community.gastro.org) received a makeover – the upgraded networking platform now features a newsfeed for difficult patient scenarios and regularly scheduled Roundtable discussions with experts in the field. In case you missed it, here are the most popular clinical discussions happening in the newsfeed:

• UC patient with new diagnosis of breast cancer (https://community.gastro.org/posts/20142)
• COVID testing before elective procedures (https://community.gastro.org/posts/21106)
• Remdesivir and hepatic failure (https://community.gastro.org/posts/21130)
• Doses of antibiotics for IBS-D patient (https://community.gastro.org/posts/19749)
• Vedolizumab and sinus migraines (https://community.gastro.org/posts/20204)

Follow and ask experts your questions in Roundtable:

• Resumption of elective endoscopy during COVID-19
• COVID-19 and GI: Caring for IBD
• Q&A with EoE guideline authors
• Q&A with the U.S. Multi-Society Task Force on Colorectal Cancer: follow-up after normal colonoscopy and polypectomy

View all upcoming Roundtables in the community at https://community.gastro.org/discussions.

The AGA Community (https://community.gastro.org) received a makeover – the upgraded networking platform now features a newsfeed for difficult patient scenarios and regularly scheduled Roundtable discussions with experts in the field. In case you missed it, here are the most popular clinical discussions happening in the newsfeed:

• UC patient with new diagnosis of breast cancer (https://community.gastro.org/posts/20142)
• COVID testing before elective procedures (https://community.gastro.org/posts/21106)
• Remdesivir and hepatic failure (https://community.gastro.org/posts/21130)
• Doses of antibiotics for IBS-D patient (https://community.gastro.org/posts/19749)
• Vedolizumab and sinus migraines (https://community.gastro.org/posts/20204)

Follow and ask experts your questions in Roundtable:

• Resumption of elective endoscopy during COVID-19
• COVID-19 and GI: Caring for IBD
• Q&A with EoE guideline authors
• Q&A with the U.S. Multi-Society Task Force on Colorectal Cancer: follow-up after normal colonoscopy and polypectomy

View all upcoming Roundtables in the community at https://community.gastro.org/discussions.

The AGA Community (https://community.gastro.org) received a makeover – the upgraded networking platform now features a newsfeed for difficult patient scenarios and regularly scheduled Roundtable discussions with experts in the field. In case you missed it, here are the most popular clinical discussions happening in the newsfeed:

• UC patient with new diagnosis of breast cancer (https://community.gastro.org/posts/20142)
• COVID testing before elective procedures (https://community.gastro.org/posts/21106)
• Remdesivir and hepatic failure (https://community.gastro.org/posts/21130)
• Doses of antibiotics for IBS-D patient (https://community.gastro.org/posts/19749)
• Vedolizumab and sinus migraines (https://community.gastro.org/posts/20204)

Follow and ask experts your questions in Roundtable:

• Resumption of elective endoscopy during COVID-19
• COVID-19 and GI: Caring for IBD
• Q&A with EoE guideline authors
• Q&A with the U.S. Multi-Society Task Force on Colorectal Cancer: follow-up after normal colonoscopy and polypectomy

View all upcoming Roundtables in the community at https://community.gastro.org/discussions.

This article is brought you by AGA PAC, a voluntary, non-partisan political organization affiliated with and supported by AGA and the only political action committee supported by a national gastroenterology society. Its mission is to give gastroenterologists a greater presence on Capitol Hill and a more effective voice in policy discussions.

The 116th Congress is well represented by the physician community, featuring a total of 17 physicians: 3 in the U.S. Senate and 14 in the House of Representatives. One of the physicians in the House, Rep. Roger Marshall, MD, R-KS, is an OBGYN by trade who is currently serving his second term in Congress. First elected in 2016, he arrived in Washington as one of only two physicians in his freshman class. He actively engaged in health care policy from the very beginning, working across party lines on a range of health care issues facing Capitol Hill. Upon entering Congress, he proactively reached out to AGA as well as other specialty physician organizations to learn our priority issues and expressed his desire to serve as a champion of the physician community.

In addition to the two committees he sits on, Dr. Marshall also serves as the chairman of the health task force for the Republican Study Committee. Additionally, Dr. Marshall is a member of the GOP Doctors Caucus, a coalition of 21 Republican medical providers with a mission statement “to utilize medical expertise to develop patient-centered health care reforms focused on quality, access, affordability, portability, and choice.” The GOP Doctors Caucus was instrumental in pushing for a permanent repeal of the sustainable growth rate (SGR) and helped to coalesce bipartisan, bicameral support for repeal legislation in the 113th Congress. The GOP Doctors Caucus continues to be active in the current Congress, advocating for policies that strengthen both the patient and provider communities.

As a member of the GOP Doctors Caucus and as a physician held in high regard by his House colleagues, Dr. Marshall is uniquely situated to advance agendas and legislative priorities that promote sound health care policy. He willingly works across the aisle with his Democratic counterparts on legislation of importance to the physician and patient community. Dr. Marshall recently worked with one of his Democratic, physician colleagues, Rep. Ami Bera, MD, D-CA, on the Improving Seniors Timely Access to Care Act, legislation addressing prior authorization burdens in Medicare Advantage plans. Dr. Marshall has vocalized the importance of physicians getting involved in the political process and to that effect, spoke to AGA members at AGA’s annual Advocacy Day about his experience as a physician running for Congress and the importance of physician advocacy.

Dr. Marshall is running for the open Senate seat in Kansas. Given that Dr. Marshall has reiterated his desire to continue to work with the physician community to ensure access to care for our patients, AGA looks forward to supporting Dr. Marshall’s Senate candidacy and continuing to work with him and his office on issues and initiatives to advance the science and practice of gastroenterology.

ginews@gastro.org

This article is brought you by AGA PAC, a voluntary, non-partisan political organization affiliated with and supported by AGA and the only political action committee supported by a national gastroenterology society. Its mission is to give gastroenterologists a greater presence on Capitol Hill and a more effective voice in policy discussions.

The 116th Congress is well represented by the physician community, featuring a total of 17 physicians: 3 in the U.S. Senate and 14 in the House of Representatives. One of the physicians in the House, Rep. Roger Marshall, MD, R-KS, is an OBGYN by trade who is currently serving his second term in Congress. First elected in 2016, he arrived in Washington as one of only two physicians in his freshman class. He actively engaged in health care policy from the very beginning, working across party lines on a range of health care issues facing Capitol Hill. Upon entering Congress, he proactively reached out to AGA as well as other specialty physician organizations to learn our priority issues and expressed his desire to serve as a champion of the physician community.

In addition to the two committees he sits on, Dr. Marshall also serves as the chairman of the health task force for the Republican Study Committee. Additionally, Dr. Marshall is a member of the GOP Doctors Caucus, a coalition of 21 Republican medical providers with a mission statement “to utilize medical expertise to develop patient-centered health care reforms focused on quality, access, affordability, portability, and choice.” The GOP Doctors Caucus was instrumental in pushing for a permanent repeal of the sustainable growth rate (SGR) and helped to coalesce bipartisan, bicameral support for repeal legislation in the 113th Congress. The GOP Doctors Caucus continues to be active in the current Congress, advocating for policies that strengthen both the patient and provider communities.

As a member of the GOP Doctors Caucus and as a physician held in high regard by his House colleagues, Dr. Marshall is uniquely situated to advance agendas and legislative priorities that promote sound health care policy. He willingly works across the aisle with his Democratic counterparts on legislation of importance to the physician and patient community. Dr. Marshall recently worked with one of his Democratic, physician colleagues, Rep. Ami Bera, MD, D-CA, on the Improving Seniors Timely Access to Care Act, legislation addressing prior authorization burdens in Medicare Advantage plans. Dr. Marshall has vocalized the importance of physicians getting involved in the political process and to that effect, spoke to AGA members at AGA’s annual Advocacy Day about his experience as a physician running for Congress and the importance of physician advocacy.

Dr. Marshall is running for the open Senate seat in Kansas. Given that Dr. Marshall has reiterated his desire to continue to work with the physician community to ensure access to care for our patients, AGA looks forward to supporting Dr. Marshall’s Senate candidacy and continuing to work with him and his office on issues and initiatives to advance the science and practice of gastroenterology.

ginews@gastro.org

This article is brought you by AGA PAC, a voluntary, non-partisan political organization affiliated with and supported by AGA and the only political action committee supported by a national gastroenterology society. Its mission is to give gastroenterologists a greater presence on Capitol Hill and a more effective voice in policy discussions.

The 116th Congress is well represented by the physician community, featuring a total of 17 physicians: 3 in the U.S. Senate and 14 in the House of Representatives. One of the physicians in the House, Rep. Roger Marshall, MD, R-KS, is an OBGYN by trade who is currently serving his second term in Congress. First elected in 2016, he arrived in Washington as one of only two physicians in his freshman class. He actively engaged in health care policy from the very beginning, working across party lines on a range of health care issues facing Capitol Hill. Upon entering Congress, he proactively reached out to AGA as well as other specialty physician organizations to learn our priority issues and expressed his desire to serve as a champion of the physician community.

In addition to the two committees he sits on, Dr. Marshall also serves as the chairman of the health task force for the Republican Study Committee. Additionally, Dr. Marshall is a member of the GOP Doctors Caucus, a coalition of 21 Republican medical providers with a mission statement “to utilize medical expertise to develop patient-centered health care reforms focused on quality, access, affordability, portability, and choice.” The GOP Doctors Caucus was instrumental in pushing for a permanent repeal of the sustainable growth rate (SGR) and helped to coalesce bipartisan, bicameral support for repeal legislation in the 113th Congress. The GOP Doctors Caucus continues to be active in the current Congress, advocating for policies that strengthen both the patient and provider communities.

As a member of the GOP Doctors Caucus and as a physician held in high regard by his House colleagues, Dr. Marshall is uniquely situated to advance agendas and legislative priorities that promote sound health care policy. He willingly works across the aisle with his Democratic counterparts on legislation of importance to the physician and patient community. Dr. Marshall recently worked with one of his Democratic, physician colleagues, Rep. Ami Bera, MD, D-CA, on the Improving Seniors Timely Access to Care Act, legislation addressing prior authorization burdens in Medicare Advantage plans. Dr. Marshall has vocalized the importance of physicians getting involved in the political process and to that effect, spoke to AGA members at AGA’s annual Advocacy Day about his experience as a physician running for Congress and the importance of physician advocacy.

Dr. Marshall is running for the open Senate seat in Kansas. Given that Dr. Marshall has reiterated his desire to continue to work with the physician community to ensure access to care for our patients, AGA looks forward to supporting Dr. Marshall’s Senate candidacy and continuing to work with him and his office on issues and initiatives to advance the science and practice of gastroenterology.

ginews@gastro.org

AGA just released GI Distance Learning, agau.gastro.org/diweb/catalog/q/GI-Distance-Learning, a new initiative providing AGA trainee members and medical residents a complementary set of curated education and career development resources available online. A part of AGA University, GI Distance Learning enables you to enhance your knowledge in a number of GI-related topics at your own pace from the comfort of home.

Through GI Distance Learning, you will have free access until Aug. 1 to the 800+ questions and answers included in the DDSEP^® 9 Question Bank. Assess your knowledge, identify gaps in learning, and stay current on the latest advances in GI and liver disease.

To access the Question Bank free of charge:

• Visit AGA University and sign in to your AGA account.
• Go to the DDSEP 9 Question Bank.
• Add the Question Bank to your Cart and Checkout.
• Type DDSEP9Distance in the Discount Code box.
• Apply the discount and submit your order.
• Use the My Courses link to access the Question Bank.

During the COVID-19 pandemic, many of us are struggling with the new normal and changes in our daily routines. Resiliency, emotional intelligence, and strategies for combatting burnout become increasingly important. The following on-demand resources from GI Distance Learning can help.

• Resilient Leadership
• Emotional Intelligence
• Strategies to Combat Burnout in GI and Maintaining Work/Life Balance

Continue to check back regularly at AGA University as we will continue to add resources to GI Distance Learning in the coming weeks.

ginews@gastro.org

AGA just released GI Distance Learning, agau.gastro.org/diweb/catalog/q/GI-Distance-Learning, a new initiative providing AGA trainee members and medical residents a complementary set of curated education and career development resources available online. A part of AGA University, GI Distance Learning enables you to enhance your knowledge in a number of GI-related topics at your own pace from the comfort of home.

Through GI Distance Learning, you will have free access until Aug. 1 to the 800+ questions and answers included in the DDSEP^® 9 Question Bank. Assess your knowledge, identify gaps in learning, and stay current on the latest advances in GI and liver disease.

To access the Question Bank free of charge:

• Visit AGA University and sign in to your AGA account.
• Go to the DDSEP 9 Question Bank.
• Add the Question Bank to your Cart and Checkout.
• Type DDSEP9Distance in the Discount Code box.
• Apply the discount and submit your order.
• Use the My Courses link to access the Question Bank.

During the COVID-19 pandemic, many of us are struggling with the new normal and changes in our daily routines. Resiliency, emotional intelligence, and strategies for combatting burnout become increasingly important. The following on-demand resources from GI Distance Learning can help.

• Resilient Leadership
• Emotional Intelligence
• Strategies to Combat Burnout in GI and Maintaining Work/Life Balance

Continue to check back regularly at AGA University as we will continue to add resources to GI Distance Learning in the coming weeks.

ginews@gastro.org

AGA just released GI Distance Learning, agau.gastro.org/diweb/catalog/q/GI-Distance-Learning, a new initiative providing AGA trainee members and medical residents a complementary set of curated education and career development resources available online. A part of AGA University, GI Distance Learning enables you to enhance your knowledge in a number of GI-related topics at your own pace from the comfort of home.

Through GI Distance Learning, you will have free access until Aug. 1 to the 800+ questions and answers included in the DDSEP^® 9 Question Bank. Assess your knowledge, identify gaps in learning, and stay current on the latest advances in GI and liver disease.

To access the Question Bank free of charge:

• Visit AGA University and sign in to your AGA account.
• Go to the DDSEP 9 Question Bank.
• Add the Question Bank to your Cart and Checkout.
• Type DDSEP9Distance in the Discount Code box.
• Apply the discount and submit your order.
• Use the My Courses link to access the Question Bank.

During the COVID-19 pandemic, many of us are struggling with the new normal and changes in our daily routines. Resiliency, emotional intelligence, and strategies for combatting burnout become increasingly important. The following on-demand resources from GI Distance Learning can help.

• Resilient Leadership
• Emotional Intelligence
• Strategies to Combat Burnout in GI and Maintaining Work/Life Balance

Continue to check back regularly at AGA University as we will continue to add resources to GI Distance Learning in the coming weeks.

ginews@gastro.org

Since the beginning of the pandemic, AGA has objected to the Centers for Medicare & Medicaid Services’ (CMS) low reimbursement rate for evaluation and management (E/M) services provided by telephone. Today, CMS fixed the problem. Retroactive to March 1, 2020, CMS will pay E/M services provided by telephone at the same rate as in-person, office/outpatient E/M services.

Thanks to everyone who helped us push CMS to address this issue. AGA worked together in coalition with other specialties and Congress on resolving this problem from the start of the pandemic.

Here are more details:

• Medicare’s updated guidance to physicians states, “Medicare payment for the telephone evaluation and management visits (CPT codes 99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established patients effective March 1, 2020.
• The CMS press release outlined the new rates for telephone E/M:
• CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.

We are pleased CMS listened to our message and has addressed this issue. Join the discussion on the AGA Community.

ginews@gastro.org

Since the beginning of the pandemic, AGA has objected to the Centers for Medicare & Medicaid Services’ (CMS) low reimbursement rate for evaluation and management (E/M) services provided by telephone. Today, CMS fixed the problem. Retroactive to March 1, 2020, CMS will pay E/M services provided by telephone at the same rate as in-person, office/outpatient E/M services.

Thanks to everyone who helped us push CMS to address this issue. AGA worked together in coalition with other specialties and Congress on resolving this problem from the start of the pandemic.

Here are more details:

• Medicare’s updated guidance to physicians states, “Medicare payment for the telephone evaluation and management visits (CPT codes 99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established patients effective March 1, 2020.
• The CMS press release outlined the new rates for telephone E/M:
• CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.

We are pleased CMS listened to our message and has addressed this issue. Join the discussion on the AGA Community.

ginews@gastro.org

Since the beginning of the pandemic, AGA has objected to the Centers for Medicare & Medicaid Services’ (CMS) low reimbursement rate for evaluation and management (E/M) services provided by telephone. Today, CMS fixed the problem. Retroactive to March 1, 2020, CMS will pay E/M services provided by telephone at the same rate as in-person, office/outpatient E/M services.

Thanks to everyone who helped us push CMS to address this issue. AGA worked together in coalition with other specialties and Congress on resolving this problem from the start of the pandemic.

Here are more details:

• Medicare’s updated guidance to physicians states, “Medicare payment for the telephone evaluation and management visits (CPT codes 99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established patients effective March 1, 2020.
• The CMS press release outlined the new rates for telephone E/M:
• CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services from a range of about $14-$41 to about $46-$110. The payments are retroactive to March 1, 2020.

We are pleased CMS listened to our message and has addressed this issue. Join the discussion on the AGA Community.

ginews@gastro.org

AGA has published new expert recommendations in Gastroenterology: AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19.

Key guidance for gastroenterologists:

• GI symptoms are not as common in COVID-19 as previously estimated: The overall prevalence was 7.7% (95% CI 7.4 to 8.6%) for diarrhea, 7.8% (95% CI: 7.1 to 8.5%) for nausea/vomiting, and 3.6% (95% CI 3.0 to 4.3%) for abdominal pain. Notably, in outpatients, the pooled prevalence of diarrhea is lower (4.0%).
• However, COVID-19 can present atypically, with GI symptoms: COVID-19 can present with diarrhea as an initial symptom, with a pooled prevalence of 7.9% across 35 studies, encompassing 9,717 patients. Most often, diarrhea is accompanied by other upper respiratory infection symptoms. However, in some cases, diarrhea can precede other symptoms by a few days, and COVID-19 may present as isolated GI symptoms prior to the development of upper respiratory infection symptoms.
• Monitor patients with new diarrhea, nausea, or vomiting for other COVID-19 symptoms: Patients should inform gastroenterologists if they begin to experience new fever, cough, shortness of breath, or other upper respiratory infection symptoms after the onset of GI symptoms. If this occurs, testing for COVID-19 should be considered.
• Abnormalities in liver function tests should prompt thorough evaluation: Liver test abnormalities can be seen in COVID-19 (in approximately 15% of patients); however, available data support that these abnormalities are more commonly attributable to secondary effects from severe disease, rather than primary virus-mediated liver injury. Therefore, it is important to consider alternative etiologies, such as viral hepatitis, when new elevations in aminotransferases are observed.

For all seven evidence-based recommendations and a detailed discussion, review the full publication in Gastroenterology.
 

Authors: Shahnaz Sultan, Osama Altayar, Shazia M. Siddique, Perica Davitkov, Joseph D. Feuerstein, Joseph K. Lim, Yngve Falck-Ytter, Hashem B. El-Serag on behalf of the AGA.

ginews@gastro.org

AGA has published new expert recommendations in Gastroenterology: AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19.

Key guidance for gastroenterologists:

• GI symptoms are not as common in COVID-19 as previously estimated: The overall prevalence was 7.7% (95% CI 7.4 to 8.6%) for diarrhea, 7.8% (95% CI: 7.1 to 8.5%) for nausea/vomiting, and 3.6% (95% CI 3.0 to 4.3%) for abdominal pain. Notably, in outpatients, the pooled prevalence of diarrhea is lower (4.0%).
• However, COVID-19 can present atypically, with GI symptoms: COVID-19 can present with diarrhea as an initial symptom, with a pooled prevalence of 7.9% across 35 studies, encompassing 9,717 patients. Most often, diarrhea is accompanied by other upper respiratory infection symptoms. However, in some cases, diarrhea can precede other symptoms by a few days, and COVID-19 may present as isolated GI symptoms prior to the development of upper respiratory infection symptoms.
• Monitor patients with new diarrhea, nausea, or vomiting for other COVID-19 symptoms: Patients should inform gastroenterologists if they begin to experience new fever, cough, shortness of breath, or other upper respiratory infection symptoms after the onset of GI symptoms. If this occurs, testing for COVID-19 should be considered.
• Abnormalities in liver function tests should prompt thorough evaluation: Liver test abnormalities can be seen in COVID-19 (in approximately 15% of patients); however, available data support that these abnormalities are more commonly attributable to secondary effects from severe disease, rather than primary virus-mediated liver injury. Therefore, it is important to consider alternative etiologies, such as viral hepatitis, when new elevations in aminotransferases are observed.

For all seven evidence-based recommendations and a detailed discussion, review the full publication in Gastroenterology.
 

Authors: Shahnaz Sultan, Osama Altayar, Shazia M. Siddique, Perica Davitkov, Joseph D. Feuerstein, Joseph K. Lim, Yngve Falck-Ytter, Hashem B. El-Serag on behalf of the AGA.

ginews@gastro.org

AGA has published new expert recommendations in Gastroenterology: AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19, Meta-Analysis of International Data, and Recommendations for the Consultative Management of Patients with COVID-19.

Key guidance for gastroenterologists:

• GI symptoms are not as common in COVID-19 as previously estimated: The overall prevalence was 7.7% (95% CI 7.4 to 8.6%) for diarrhea, 7.8% (95% CI: 7.1 to 8.5%) for nausea/vomiting, and 3.6% (95% CI 3.0 to 4.3%) for abdominal pain. Notably, in outpatients, the pooled prevalence of diarrhea is lower (4.0%).
• However, COVID-19 can present atypically, with GI symptoms: COVID-19 can present with diarrhea as an initial symptom, with a pooled prevalence of 7.9% across 35 studies, encompassing 9,717 patients. Most often, diarrhea is accompanied by other upper respiratory infection symptoms. However, in some cases, diarrhea can precede other symptoms by a few days, and COVID-19 may present as isolated GI symptoms prior to the development of upper respiratory infection symptoms.
• Monitor patients with new diarrhea, nausea, or vomiting for other COVID-19 symptoms: Patients should inform gastroenterologists if they begin to experience new fever, cough, shortness of breath, or other upper respiratory infection symptoms after the onset of GI symptoms. If this occurs, testing for COVID-19 should be considered.
• Abnormalities in liver function tests should prompt thorough evaluation: Liver test abnormalities can be seen in COVID-19 (in approximately 15% of patients); however, available data support that these abnormalities are more commonly attributable to secondary effects from severe disease, rather than primary virus-mediated liver injury. Therefore, it is important to consider alternative etiologies, such as viral hepatitis, when new elevations in aminotransferases are observed.

For all seven evidence-based recommendations and a detailed discussion, review the full publication in Gastroenterology.
 

Authors: Shahnaz Sultan, Osama Altayar, Shazia M. Siddique, Perica Davitkov, Joseph D. Feuerstein, Joseph K. Lim, Yngve Falck-Ytter, Hashem B. El-Serag on behalf of the AGA.

ginews@gastro.org

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

ginews@gastro.org

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

ginews@gastro.org

AGA has advocated for provisions to protect our providers and businesses and we’re happy to report that the following provisions are in the third installation of the COVID-19 economic relief legislation.

We’ll continue to push for direct funding for physicians recognizing that many practices and ASCs are struggling.
 

Small business relief

• Small Business Administration (SBA) loans:

Businesses with 500 employees or less are eligible unless the covered industry’s SBA size standard allows more than 500 employees.

Allows 501(c)(3) non-profits to gain access to the program.

Increases the maximum loan amount to $10 million.

Expands allowable uses of loans to include payroll support, such as:

1. Paid sick or medical leave.

2. Employee salaries.

3. Mortgage payments.

Provides a process for loan forgiveness for certain payroll costs as well as mortgage, rent and utility obligations.

• Public Health and Social Services Emergency Fund:

$100 billion for health care services related to the COVID-19.

Reimbursement to eligible health care providers for health care related expenses or lost revenues that are attributable to the pandemic.

• Coronavirus Economic Stabilization Act:

$454 billion for loans, loan guarantees and other investments for companies with losses tied to the pandemic that threaten continued operation.
 

Medicare provisions

• Suspension of sequestration – Physicians avoid a 2% cut in their Medicare reimbursement.
• Extension of geographic index floor – Increases Medicare payments for providers in nonurban areas.
• Increased Medicare telehealth flexibilities during the emergency period.
• AGA will continue to advocate for audio-only coverage as this issue is still not resolved.

Other key health care provisions

• Liability protections for health care professionals during the emergency response.
• Coverage of preventive services and vaccines.
• $16 billion to replenish the Strategic National Stockpile.
• $1 billion for the Defense Production Act to ensure production of personal protective equipment (PPE).

Correspondence to congressional leadership

• March 25, 2020 – With the American Medical Association, a letter is sent requesting the inclusion of support for physician practices in any economic stimulus package.
• March 24, 2020 – With the Alliance of Specialty Medicine, a letter is sent asking for relief for independent physicians’ offices.
• March 20, 2020 – A joint society letter is sent asking for increased funding for and access to PPE; softened prior authorization, telehealth reimbursement and Medicare reporting requirements; and financial safeguards for health care professionals and practices.

ginews@gastro.org

Dear colleagues,

The coronavirus pandemic has affected every facet of society, bringing almost unprecedented challenges to our world, and especially to our world of health care.

But our profession has been ignited in the way only a crisis can spark. Many of you are working on the front lines of patient care, at personal risk, lacking sufficient information and adequate resources. This is heroic work.

AGA’s priority during this time of disruption is to get practical guidance into your hands to help you treat patients, and protect yourselves and your coworkers. We’re also advocating on your behalf to get the resources you need and economic relief necessitated by the measures taken to fight the pandemic.

We are continually updating our COVID-19 website, www.gastro.org/covid. Check it for the latest clinical guidance, practice management information, and advocacy initiatives.

Our journals have started a collection of submissions related to COVID-19. Your AGA colleagues on the Clinical Guidelines Committee and Clinical Practice Updates Committee have been hard at work developing guidance for questions that you have asked us on Twitter, @AmerGastroAssn and the AGA Community. So join us there where resources and insights are being shared in real time.

Your commitment to our patients is a testament to your professionalism. Our commitment at AGA is to support you.

We’ll get through this together.
 

Hashem B. El-Serag, MD, MPH, AGAF
President, AGA Institute

Dear colleagues,

The coronavirus pandemic has affected every facet of society, bringing almost unprecedented challenges to our world, and especially to our world of health care.

But our profession has been ignited in the way only a crisis can spark. Many of you are working on the front lines of patient care, at personal risk, lacking sufficient information and adequate resources. This is heroic work.

AGA’s priority during this time of disruption is to get practical guidance into your hands to help you treat patients, and protect yourselves and your coworkers. We’re also advocating on your behalf to get the resources you need and economic relief necessitated by the measures taken to fight the pandemic.

We are continually updating our COVID-19 website, www.gastro.org/covid. Check it for the latest clinical guidance, practice management information, and advocacy initiatives.

Our journals have started a collection of submissions related to COVID-19. Your AGA colleagues on the Clinical Guidelines Committee and Clinical Practice Updates Committee have been hard at work developing guidance for questions that you have asked us on Twitter, @AmerGastroAssn and the AGA Community. So join us there where resources and insights are being shared in real time.

Your commitment to our patients is a testament to your professionalism. Our commitment at AGA is to support you.

We’ll get through this together.
 

Hashem B. El-Serag, MD, MPH, AGAF
President, AGA Institute

Dear colleagues,

The coronavirus pandemic has affected every facet of society, bringing almost unprecedented challenges to our world, and especially to our world of health care.

But our profession has been ignited in the way only a crisis can spark. Many of you are working on the front lines of patient care, at personal risk, lacking sufficient information and adequate resources. This is heroic work.

AGA’s priority during this time of disruption is to get practical guidance into your hands to help you treat patients, and protect yourselves and your coworkers. We’re also advocating on your behalf to get the resources you need and economic relief necessitated by the measures taken to fight the pandemic.

We are continually updating our COVID-19 website, www.gastro.org/covid. Check it for the latest clinical guidance, practice management information, and advocacy initiatives.

Our journals have started a collection of submissions related to COVID-19. Your AGA colleagues on the Clinical Guidelines Committee and Clinical Practice Updates Committee have been hard at work developing guidance for questions that you have asked us on Twitter, @AmerGastroAssn and the AGA Community. So join us there where resources and insights are being shared in real time.

Your commitment to our patients is a testament to your professionalism. Our commitment at AGA is to support you.

We’ll get through this together.
 

Hashem B. El-Serag, MD, MPH, AGAF
President, AGA Institute

Based on a review of available evidence, we have published guidance for clinicians in gastroenterology: AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic. AGA recommends increasing personal protective equipment (PPE) during all GI procedures during the coronavirus pandemic, as well as triaging procedures following a decision-making framework outlined in the recommendations document.

Review this guidance, as well as the latest AGA resources and information on coronavirus, at www.gastro.org/COVID.
 

Masks

1. In health care workers performing upper GI procedures, regardless of COVID-19 status,* AGA recommends use of N95 (or N99 or PAPR) instead of surgical masks, as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)

2. In health care workers performing lower GI procedures regardless of COVID-19 status,* AGA recommends the use of N95 (or N99 or PAPR) masks instead of surgical masks as part of appropriate personal protective equipment. (Strong recommendation, low certainty of evidence)

3. In health care workers performing upper GI procedures, in known or presumptive COVID-19 patients, AGA recommends against the use of surgical masks only, as part of adequate personal protective equipment. (Strong recommendation, low certainty of evidence)
 

Limited resource settings

4. In extreme resource-constrained settings involving health care workers performing any GI procedures, regardless of COVID-19 status,* AGA suggests extended use/re-use of N95 masks over surgical masks, as part of appropriate personal protective equipment. (Conditional recommendation, very low certainty evidence)
 

Gloves

5. In health care workers performing any GI procedure, regardless of COVID-19 status, AGA recommends the use of double gloves compared with single gloves as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)
 

Negative pressure rooms

6. In health care workers performing any GI procedures with known or presumptive COVID-19, AGA suggests the use of negative pressure rooms over regular endoscopy rooms when available. (Conditional recommendation, very low certainty of evidence)
 

Endoscopic disinfection

7. For endoscopes utilized on patients regardless of COVID-status, AGA recommends continuing standard cleaning endoscopic disinfection and reprocessing protocols. (Good practice statement)
 

Triage

8. All procedures should be reviewed by trained medical personnel and categorized as time-sensitive or not time-sensitive as a framework for triaging procedures. (Good practice statement)

9. In an open access endoscopy system where the listed indication alone may provide insufficient information to make a determination about the time-sensitive nature of the procedure, consideration should be given for the following options (i) a telephone consultation with the referring provider or (ii) a telehealth visit with the patient or (iii) a multidisciplinary team approach to facilitate decision-making for complicated patients. (Good practice statement)


*These recommendations assume the absence of widespread reliable rapid testing for the diagnosis of COVID-19 infection or immunity

For a detailed discussion, review the full publication in Gastroenterology.

This rapid recommendation document was commissioned and approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee, and the AGA Governing Board to provide timely, methodologically rigorous guidance on a topic of high clinical importance to the AGA membership and the public. Our goal is to protect health care providers and patients from coronavirus during GI procedures.
 

ginews@gastro.org

Based on a review of available evidence, we have published guidance for clinicians in gastroenterology: AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic. AGA recommends increasing personal protective equipment (PPE) during all GI procedures during the coronavirus pandemic, as well as triaging procedures following a decision-making framework outlined in the recommendations document.

Review this guidance, as well as the latest AGA resources and information on coronavirus, at www.gastro.org/COVID.
 

Masks

1. In health care workers performing upper GI procedures, regardless of COVID-19 status,* AGA recommends use of N95 (or N99 or PAPR) instead of surgical masks, as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)

2. In health care workers performing lower GI procedures regardless of COVID-19 status,* AGA recommends the use of N95 (or N99 or PAPR) masks instead of surgical masks as part of appropriate personal protective equipment. (Strong recommendation, low certainty of evidence)

3. In health care workers performing upper GI procedures, in known or presumptive COVID-19 patients, AGA recommends against the use of surgical masks only, as part of adequate personal protective equipment. (Strong recommendation, low certainty of evidence)
 

Limited resource settings

4. In extreme resource-constrained settings involving health care workers performing any GI procedures, regardless of COVID-19 status,* AGA suggests extended use/re-use of N95 masks over surgical masks, as part of appropriate personal protective equipment. (Conditional recommendation, very low certainty evidence)
 

Gloves

5. In health care workers performing any GI procedure, regardless of COVID-19 status, AGA recommends the use of double gloves compared with single gloves as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)
 

Negative pressure rooms

6. In health care workers performing any GI procedures with known or presumptive COVID-19, AGA suggests the use of negative pressure rooms over regular endoscopy rooms when available. (Conditional recommendation, very low certainty of evidence)
 

Endoscopic disinfection

7. For endoscopes utilized on patients regardless of COVID-status, AGA recommends continuing standard cleaning endoscopic disinfection and reprocessing protocols. (Good practice statement)
 

Triage

8. All procedures should be reviewed by trained medical personnel and categorized as time-sensitive or not time-sensitive as a framework for triaging procedures. (Good practice statement)

9. In an open access endoscopy system where the listed indication alone may provide insufficient information to make a determination about the time-sensitive nature of the procedure, consideration should be given for the following options (i) a telephone consultation with the referring provider or (ii) a telehealth visit with the patient or (iii) a multidisciplinary team approach to facilitate decision-making for complicated patients. (Good practice statement)


*These recommendations assume the absence of widespread reliable rapid testing for the diagnosis of COVID-19 infection or immunity

For a detailed discussion, review the full publication in Gastroenterology.

This rapid recommendation document was commissioned and approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee, and the AGA Governing Board to provide timely, methodologically rigorous guidance on a topic of high clinical importance to the AGA membership and the public. Our goal is to protect health care providers and patients from coronavirus during GI procedures.
 

ginews@gastro.org

Based on a review of available evidence, we have published guidance for clinicians in gastroenterology: AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic. AGA recommends increasing personal protective equipment (PPE) during all GI procedures during the coronavirus pandemic, as well as triaging procedures following a decision-making framework outlined in the recommendations document.

Review this guidance, as well as the latest AGA resources and information on coronavirus, at www.gastro.org/COVID.
 

Masks

1. In health care workers performing upper GI procedures, regardless of COVID-19 status,* AGA recommends use of N95 (or N99 or PAPR) instead of surgical masks, as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)

2. In health care workers performing lower GI procedures regardless of COVID-19 status,* AGA recommends the use of N95 (or N99 or PAPR) masks instead of surgical masks as part of appropriate personal protective equipment. (Strong recommendation, low certainty of evidence)

3. In health care workers performing upper GI procedures, in known or presumptive COVID-19 patients, AGA recommends against the use of surgical masks only, as part of adequate personal protective equipment. (Strong recommendation, low certainty of evidence)
 

Limited resource settings

4. In extreme resource-constrained settings involving health care workers performing any GI procedures, regardless of COVID-19 status,* AGA suggests extended use/re-use of N95 masks over surgical masks, as part of appropriate personal protective equipment. (Conditional recommendation, very low certainty evidence)
 

Gloves

5. In health care workers performing any GI procedure, regardless of COVID-19 status, AGA recommends the use of double gloves compared with single gloves as part of appropriate personal protective equipment. (Strong recommendation, moderate certainty of evidence)
 

Negative pressure rooms

6. In health care workers performing any GI procedures with known or presumptive COVID-19, AGA suggests the use of negative pressure rooms over regular endoscopy rooms when available. (Conditional recommendation, very low certainty of evidence)
 

Endoscopic disinfection

7. For endoscopes utilized on patients regardless of COVID-status, AGA recommends continuing standard cleaning endoscopic disinfection and reprocessing protocols. (Good practice statement)
 

Triage

8. All procedures should be reviewed by trained medical personnel and categorized as time-sensitive or not time-sensitive as a framework for triaging procedures. (Good practice statement)

9. In an open access endoscopy system where the listed indication alone may provide insufficient information to make a determination about the time-sensitive nature of the procedure, consideration should be given for the following options (i) a telephone consultation with the referring provider or (ii) a telehealth visit with the patient or (iii) a multidisciplinary team approach to facilitate decision-making for complicated patients. (Good practice statement)


*These recommendations assume the absence of widespread reliable rapid testing for the diagnosis of COVID-19 infection or immunity

For a detailed discussion, review the full publication in Gastroenterology.

This rapid recommendation document was commissioned and approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee, and the AGA Governing Board to provide timely, methodologically rigorous guidance on a topic of high clinical importance to the AGA membership and the public. Our goal is to protect health care providers and patients from coronavirus during GI procedures.
 

ginews@gastro.org

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent discussions addressing clinical concerns and issues arising from the COVID-19 epidemic:

eQ&A on recommendations for GI procedures during the COVID-19 pandemic – Join guideline authors in discussing AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic, published in Gastroenterology.



1. IBD patients and COVID-19 – To allow for timely dissemination throughout the IBD and international gastroenterology communities, members are sharing important updates regarding COVID-19 and IBD management.



2. Medicare COVID-19 changes and telehealth reimbursement – Share your experiences and difficulties using telehealth platforms like Skype and facetime to connect with Medicare beneficiaries during the coronavirus epidemic.



3. Anesthesia options for in-patient endoscopy – Colleagues examine whether intubation is the best approach for EGDs to minimize COVID-19 transmission risk.



Access these and more discussions at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent discussions addressing clinical concerns and issues arising from the COVID-19 epidemic:

eQ&A on recommendations for GI procedures during the COVID-19 pandemic – Join guideline authors in discussing AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic, published in Gastroenterology.



1. IBD patients and COVID-19 – To allow for timely dissemination throughout the IBD and international gastroenterology communities, members are sharing important updates regarding COVID-19 and IBD management.



2. Medicare COVID-19 changes and telehealth reimbursement – Share your experiences and difficulties using telehealth platforms like Skype and facetime to connect with Medicare beneficiaries during the coronavirus epidemic.



3. Anesthesia options for in-patient endoscopy – Colleagues examine whether intubation is the best approach for EGDs to minimize COVID-19 transmission risk.



Access these and more discussions at https://community.gastro.org/discussions.

Physicians with difficult patient scenarios regularly bring their questions to the AGA Community to seek advice from colleagues about therapy and disease management options, best practices, and diagnoses.

Here are some recent discussions addressing clinical concerns and issues arising from the COVID-19 epidemic:

eQ&A on recommendations for GI procedures during the COVID-19 pandemic – Join guideline authors in discussing AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic, published in Gastroenterology.



1. IBD patients and COVID-19 – To allow for timely dissemination throughout the IBD and international gastroenterology communities, members are sharing important updates regarding COVID-19 and IBD management.



2. Medicare COVID-19 changes and telehealth reimbursement – Share your experiences and difficulties using telehealth platforms like Skype and facetime to connect with Medicare beneficiaries during the coronavirus epidemic.



3. Anesthesia options for in-patient endoscopy – Colleagues examine whether intubation is the best approach for EGDs to minimize COVID-19 transmission risk.



Access these and more discussions at https://community.gastro.org/discussions.