2017-06-01 14:20:18 UTC

Tell CMS: Proposed Rules for Hospitals Will Affect GI Practice

June 1, 2017

Medicare has proposed rules that could hinder GIs' care of patients; ensure CMS knows how it will affect you.

The CMS Medicare Inpatient Prospective Payment System (IPPS) proposed rule will affect hospital payments for 2018. AGA will submit comments to CMS and needs your help to share how proposed changes will impact you.  

Public Access to ASC Accreditation Surveys
CMS proposes making ambulatory surgery center (ASC) accreditation surveys open to the public without explaining what the findings mean to patients. If implemented, the proposed rules would require accreditation organizations to publicly post all final accreditation survey reports, including triennial, full, follow-up, focused and complaint surveys, as well as plans of correction. Data for the most recent three years would be posted. These changes are proposed under the guise of increasing transparency to give patients access to confidential data. Without providing a framework for understanding the data and how to use it, patients are likely to misinterpret the findings, which could hinder patient care. AGA is asking the gastroenterology community to urge CMS to not require public posting of accreditation survey data until plans for helping patients understand it are created.

Payment Cuts to Hospital-based GI Care
In the 2018 proposed rule, payment for certain GI care provided in the hospital would be cut by as much as 25 percent. These payment cuts are too steep and should not be fully implemented. AGA is asking the gastroenterology community to press CMS to cap payment cuts in 2018 and investigate what’s driving them before implementing further reductions. This is the first year that claims with ICD-10 codes are being used to set payment amounts and it’s important to understand how this change may have impacted payments before implementing such cuts. 

ASC-based GIs May be Excluded from Negative Payments
CMS has also proposed rules that would exclude GIs considered ASC-based from negative payment adjustments under the electronic health reacord (EHR) Incentive Program. Two options are being considered — option one would define a GI as ASC-based if 75 percent or more of Medicare services are billed in an ASC. Option two would define a GI as ASC-based if 90 percent or more of Medicare services are billed in an ASC. Both options create a gap where gastroenterologists that provide more than 50 percent of Medicare services in an ASC, but less than 75 or 90 percent are unable to qualify as meaningful users. AGA is asking the gastroenterology community to applaud CMS and to recommend that CMS adopt an alternative threshold. 

Your Voice is Key

The gastroenterology community needs to contact CMS to protest negative changes and applaud positive ones. New proposals from CMS must include input from GIs. 

Take Action

Visit the official federal government portal for submitting public comments on the proposed rule no later than 5 p.m. ET on Tuesday, June 13.

  • Open and revise the template letter to include your name, practice name and location.
  • If interested, supplement the letter with any of your personal experiences that you want considered.
  • Copy and paste the template letter into the box labeled “Comment.”  
  • Enter your individual contact information and press the blue “Continue” button at the bottom of the page.
  • Review, complete the acknowledgement and submit. 

Please reach out to CMS today to ensure that the voices of GIs are heard.

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