American Gastroenterological Association - Advancing the Science and Practice of Gastroenterology

AGA Continues Campaign to Secure Seat

On March 12, 2006, leadership from the AGA Institute (AGAI), American Association for the Study of Liver Disease (AASLD), American College of Gastroenterology (ACG) and the American Society for Gastrointestinal Endoscopy (ASGE) met with the leadership of the American Medical Association (AMA) to discuss obtaining a permanent voting position for gastroenterology on the AMA Relative Value Update Committee (RUC). Our unified message to the AMA was that, “GI meets the RUC seat criterion and should be granted a permanent seat.” The meeting was the culmination of over one year of effort to secure a seat on the RUC.

In 1991, the AMA/Specialty RVS Update Committee (RUC) was formed to make recommendations to CMS on the relative values to be assigned to new or revised codes in Physicians Current Procedural Terminology (CPT). Recommendation and decisions made by the RUC have significant impact on the annual updates to the physician work relative values. For that reason AGAI and the other societies have played an active role with both the CPT and RUC processes for over a decade; AGAI has an advisor and staff that are dedicated solely to the Committee’s work. We have brought hundreds of CPT coding applications before the CPT panel and conducted hundreds of RUC surveys in order to obtain “fair” reimbursement for GI procedures. Gastroenterology has held one of the two rotating seats that are granted to internal medicine specialties from 1991-1994 and from 2003-2005, which only heightened our awareness of the importance of a permanent seat and voting power.

Gastroenterology has not been granted a full seat on the RUC, though it meets the five criteria for obtaining a seat that have existed since the inception of the RUC. Several members of the RUC do not meet those criteria, but were exempted from their application at the same time a joint-GI application for a permanent seat was denied.

The March 12, 2006, meeting with the AMA Board members was the culmination of over a year’s worth of requests and denials for a permanent seat. Presidents and Executive Vice Presidents/Directors and staff from the AGAI, AASLD, ACG and ASGE came together and met with AMA leaders to argue that the AMA must follow its own rules and grant us a permanent RUC seat. According to the AMA Board they have "influence over the RUC, but not control" and appear to be bound by the resolutions of the House of Delegates. One thing that is clear from the meeting is that the AMA itself is not clear how the rules are to be applied. The GI societies stressed the need for transparency in selecting and maintaining seats on the RUC in an open and fair process. The AMA is putting the RUC’s reputation and process at risk with its cartel-like behavior as the RUC is run by a group of "insiders" who exclude others and make payment decisions that affect the entire medicine community.

The societies will meet to determine the appropriate next steps during the next teleconference of the four society Presidents, and will continue to fight on your behalf for voting power to ensure that adequate reimbursements are assigned to GI codes.

 

March 2006