Gastroenterology Quarterly Update: October 2017
Oct. 4, 2017Audio conference timed with with quarterly release of the Correct Coding Initiative edits.
Digestive Disease Week® (DDW)
May 6, 2017Digestive Disease Week® (DDW) is the premier meeting for the GI professional. Every year it attracts approximately 15,000 physicians, researchers and academics from around the world who desire to stay up-to-date in the field.
Gastroenterology Quarterly Update: April 2017
April 5, 2017Audio conference timed with with quarterly release of the Correct Coding Initiative edits.
Submit 2016 PQRS Data by Feb. 28
Feb. 17, 2017Clinicians who treat Medicare Part B patients and submit data may earn a bonus on 2016 Medicare Part B allowable charges.
AGA Attends CMS Listening Session
Feb. 2, 2017The meeting provided a venue for AGA to advocate for GI.
AGA Supports Physician-Focused Payment Models
Feb. 1, 2017AGA is committed to preparing GIs for success in new reimbursement environments.
There’s Still Time — Report 2016 PQRS Data
Jan. 25, 2017Submitting data by Feb. 28 can help you receive a bonus payment in 2018.
MACRA is Not Going Away: Will You Be Ready?
Jan. 25, 2017Use the 2017 transition year to learn how to be successful under MACRA.
New Administration Will Bring Changes, AGA Wants Patients Protected
Jan. 19, 2017ACA repeal without a replacement could result in millions of uninsured patients and millions of dollars in uncompensated care to providers.
CMS Requires Post-Op Visit Tracking for Hemorrhoid Ligation
Jan. 11, 2017Medicare providers in nine states will have to track the visits starting July 1, 2017.
ICD-10 Update Snag Means Some May Avoid PQRS Penalties
Jan. 11, 2017CMS will analyze 2016 data to determine which practices and practitioners were negatively affected.
AGA Asks for Continued Flexibility in MACRA Final Rule
Dec. 19, 2016CMS should extend the payment program transition period and include meaningful GI measures to improve patient outcomes.
Learn About MACRA Through On-Demand and Live Webinars
Dec. 14, 2016The first two webinars are now available for members in the AGA Community library. Join discussion threads on both topics in the community as well.
Use AGA's DHRP™ to Meet 2016 Reporting Requirements
Dec. 14, 2016Data needs to be submitted by mid-February to meet 2016 Physician Quality Reporting System requirements.
Five Tips to Prepare for MACRA
Nov. 29, 2016As 2016 draws to a close, there are several steps you can take to ensure your practice is ready for 2017.
CMS Releases HOPPS and ASC Final Rule for CY2017
Nov. 7, 2016Payment rates increase for both programs.
CMS Releases 2017 Medicare Physician Fee Schedule Final Rule
Nov. 3, 2016CMS created new moderate sedation codes for GI endoscopy procedures, which need to be billed separately.
CMS Website Helps GIs Prepare for MACRA
Oct. 25, 2016Eligible clinicians need to participate in the Quality Payment Program.
GI Quality Measures for 2017 Released in MACRA Final Rule
Oct. 19, 2016While 2017 is a transition year for MACRA, GIs need to report quality measures to succeed.
MACRA Final Rule — 2017 is a Transition Year
Oct. 14, 2016When MACRA implementation begins on Jan. 1, GIs will be able to pick their pace for participation. Read AGA's overview and resources to help prepare for the upcoming changes.
Congress Passes Continuing Resolution, Avoids Shutdown
Oct. 10, 2016Expected busy lame-duck session could focus on many of GI's priorities.
AGA Comments on CMS Episode Payment Models Proposed Rule
Oct. 6, 2016AGA encourages availability of advanced GI EPMs, but opposes mandatory condition- or outpatient-based models.
AGA Members Take Capitol Hill
Sept. 28, 2016Members from around the country visited Congress during AGA Advocacy Day to fight for the future of GI.
AGA Meets with CMS on Sedation
Sept. 16, 2016We reinforced our recommendations on important payment issues impacting GI in the proposed rules.
CMS Slows MACRA Timeline
Sept. 9, 2016New MACRA schedule allows you to pick the pace for your participation.
AGA Advocates to CMS for GI APMs
Sept. 8, 2016AGA met with CMS officials to highlight the importance of including GI specialty alternative payment models under MACRA.
Tell Congress — Oversight of MACRA Implementation Needed
Sept. 6, 2016Join us for Virtual Advocacy Day on Sept. 16 to ensure Congress hears the voice of GI about MACRA.
New Reporting Rules for Claims with Discarded Drugs
Aug. 30, 2016The JW modifier should be used with all claims for the amount of discarded Part B drugs and biologics, as of Jan. 1, 2017.
CMS ICD-10 'Grace Period' Coming to an End
Aug. 24, 2016Beginning Oct. 1, physician coding needs to include more specificity.
Moving Targets: Latest AGA Practice Management Updates
Aug. 24, 2016Dr. Sarah Streett introduces a new set of articles to help your practice of GI and patient care.
ACOs: Shared Savings Beyond Medicare and Opportunities for Small Practices
Aug. 22, 2016Dr. Geetanjali Akerkar highlights paths to success for GI practices in the age of MACRA.
Sen. Bill Cassidy — Legislative Champion for Health-Care Professionals
Aug. 10, 2016Dr. Joel Brill writes about Sen. Cassidy's role in the development of the MACRA regulation and how he's helping to ensure GIs can navigate it.
HHS Finalizes Rule on Nondiscrimination in Health Care
Aug. 9, 2016Health-care entities participating in federally-funded programs need to understand the rule to ensure they prevent discrimination
Are You Running Afoul of the HHS Rule on Nondiscrimination?
Aug. 9, 2016New rules prevent discrimination in all federally funded health programs and activities.
Florida Physicians: Medicare Recoups Overpayments
Aug. 2, 2016System error did not account for 2 percent payment reduction by CMS.
Presentations Highlight the Latest in Innovation in GI
Aug. 2, 2016Select presentations from the 2016 AGA Tech Summit are now available on the AGA website.
Joint Commission Reinstates Ban on Text Orders
Aug. 2, 2016The program will be delayed until late fall 2016.
Improperly Denied HCV Testing Claims to be Paid
Aug. 1, 2016Medicare administrative contractors will reprocess the claims automatically.
Medicare’s Planned Overhaul of Moderate Sedation Impacts Everyone
July 28, 2016CMS has proposed values for new moderate sedation codes, which will impact the way GIs are reimbursed. Read AGA's analysis on this proposal.
2016 AGA Tech Summit Selections
July 28, 20162016 AGA Tech Summit Selections
In-Depth Analysis of Proposed 2017 Medicare Rules
July 18, 2016We've summarized the key provisions of the Physician Fee Schedule and HOPPS/ASC proposed rules.
ASC and Hospital Outpatient Rules Released
July 7, 2016CMS recommended changes to the amounts and factors used to determine the payment rates for Medicare services.
Medicare Proposes to Remove Moderate Sedation from Endoscopic Procedures
July 7, 2016Separate code will be valued for moderate sedation services in the 2017 Physician Fee Schedule.
AGA Presents Need for Specialty Alternative Payment Models to CMS and Congress
June 29, 2016Specialists should be able to qualify for alternative payment models under MACRA.
New Colonoscopy Consultation Code May be Required
June 29, 2016GIs may be able to report new code for non-Medicare patients.
AGA Comments on MACRA Proposed Rule
June 28, 2016We've asked CMS for dozens of changes that are needed to make MACRA work for GIs without limiting patients' access to crucial specialty care.
Make Sure CMS Includes GI Voices in MACRA Rules
June 15, 2016The MACRA proposed rule could hinder GIs' care of patients; ensure CMS knows how it will affect you.
ICYMI: MACRA Info from DDW®
June 1, 2016Read info from AGA sessions at DDW and use our online guide to understand how to report on and measure quality so you can prepare your practice for success.
Prepare Your Practice for New Payment Models
May 31, 2016Learn how you can build and sustain a successful GI practice in an era of value-based care.
Gain Practical Insight to Plan for the Future of Reimbursement
May 17, 2016These DDW sessions will help you prepare for upcoming changes to reimbursement.
Use These AGA Tools to Learn about MACRA
May 12, 2016MACRA replaces the flawed sustainable growth rate and significantly changes the way Medicare pays physicians.
Get Answers to All of Your Coding Questions
May 9, 2016AGA members receive two free questions per month through the AGA Coding & Billing Corner.
Barrett's Esophagus Overview Featured in The New Gastroenterologist
May 5, 2016The latest issue also dives into topics such as Medicare, pursuing a career in private practice and even home-buying.
Interesting Stats: MACRA’s GI Impact
April 28, 2016MACRA will revolutionize key programs that determine Medicare reimbursement.
Tell CMS: Stop Cuts to Medicare Part B Reimbursement
April 27, 2016Proposed changes to Medicare reimbursement could affect GI patient care.
GI Outlook 2016: Enhance the Efficiency and Profitability of Your Practice
April 27, 2016The ASGE-AGA GI Outlook Practice Management Conference will take place Aug. 5 through 7 in Washington, DC.
CMS Releases MACRA Quality, Payment Rules
April 27, 2016The MACRA proposed rule could significantly change physician reimbursement programs.
CMS Approves AGA Qualified Clinical Data Registry
April 25, 2016Gastroenterologists can use the registry to satisfy 2016 PQRS reporting requirements.
Is Your ASC Exempt From the ASCQR Program for 2017?
April 20, 2016Exempt facilities can still voluntarily participate with no risk of payment penalties.
10 Practical Steps to Prepare for MACRA
April 20, 2016AGA offers tips and programs to help you prepare for and thrive in an accountable care environment.
CMS Releases 2015 Mid-Year Quality and Resource Use Reports
April 18, 2016Physicians are encouraged to review their reports to understand their performance for the value-based modifier.
AGA Advocates for Inclusion of Specialists in Alternative Payment Models
April 14, 2016Drs. Larry Kosinski and Joel Brill met with lawmakers on Capitol Hill to highlight AGA payment initiatives and frameworks.
Tell Congress: Stop Medicare Part B Changes
April 12, 2016If implemented, the proposed rule could disrupt patients' medication treatment.
Now Available: Open Payments Data for Physician Review
April 5, 2016All eligible professionals are encouraged to review their data during the 45-day review period.
Changes in Health-Care Reimbursement
April 1, 2016John I. Allen, MD, MBA, AGAF, offers insight about the changes in health-care reimbursement and the appeal of academic careers.
Changes Coming to Moderate Sedation Will Impact GI Procedures
March 16, 2016CMS intends to remove the value of moderate sedation from all GI endoscopy codes.
Meaningful Use Deadlines Approaching in March
Feb. 24, 2016Eligible professionals are able to attest for meaningful use or apply for a hardship exemption, but must do so by the March CMS deadlines.
CMS, Major Commercial Health Plans Announce Alignment of Quality Measures
Feb. 17, 2016AGA was integral in providing input into the core GI measures.
Sign Up for AGA’s Last DHRP™ Webinar of the Season
Feb. 17, 2016Register for the Feb. 25 webinar to learn how to avoid CMS reimbursement penalties.
Trainees: Get Familiar with the Business Side of GI
Feb. 15, 2016Come explore what the future holds for GI health care at the AGA Partners in Quality Meeting on March 11 in Washington, DC.
CMS Releases New Overpayment Rules for Medicare
Feb. 12, 2016The agency has clarified how and when providers are required to return Medicare overpayments.
Proposed 2017 Budget Includes Funding for Key AGA Priorities
Feb. 11, 2016Proposal includes fix to current Medicare screening colonoscopy coinsurance problem.
CMS Extends Deadline for PQRS Submission
Feb. 3, 2016You now have a few more weeks to submit 2015 data for the CMS Physician Quality Reporting System (PQRS).
CMS Releases Application for New Meaningful Use Exception
Jan. 27, 2016Eligible professionals can apply for the hardship exemption by March 15, 2016.
Medicare Refines 2016 MPFS Payments
Jan. 19, 2016We've compiled a list of the codes that experienced the greatest reductions to the non-facility (office) setting.
Dr. Camilleri: My Day Advocating for GI on Capitol Hill
Jan. 19, 2016While advocating for GI on Capitol Hill, AGA President Michael Camilleri, MD, learned that Congress wants to hear from the experts.
Washington Returns to Work after Winter Break
Jan. 14, 2016It's going to be a busy year in Washington. AGA continues to advocate for the science and practice of GI, and our patients.
Cognitive Care Specialties Form New Coalition to Save Cognitive Care
Jan. 13, 2016AGA joins alliance to support proper reimbursement for specialty care.
CMS Corrects 2016 Payments
Jan. 13, 2016CMS has corrected technical errors in the 2016 Medicare Physician Fee Schedule.
Is Your Practice Prepared to Meet the Demands of Value-Based Care?
Jan. 11, 2016Attend AGA's Partners in Quality meeting on March 11, 2016, to help your practice thrive.
Top New Year’s Resolutions for Your Practice
Jan. 5, 2016AGA leaders Drs. Sarah Streett and Joel Brill provide tips to help you prepare your practice for 2016.
Enroll in AGA’s Jan. 28 or Feb. 25 Webinars on DHRP
Jan. 4, 2016AGA developed DHRP™ to provide clinicians with an easy way to avoid CMS and payor penalties by demonstrating superior quality of care.
Coverage Update: Screening Colonoscopy Cost Sharing
Dec. 10, 2015Confusion still exists about how the Medicare CRC screening benefit is covered and we've put together a quick summary of the latest updates to help clarify this.
CMS Extends Deadline for PQRS Review
Dec. 1, 2015There's still time to review your 2014 data to potentially avoid payment penalties.
Updated Payments for Incomplete Colonoscopies
Nov. 30, 2015Make sure to alert your billing staff to these revisions for calculating payments.
2016 Medicare Physician Fee Schedule: Analysis & Practical Information
Nov. 16, 2015AGA summarizes key provisions to help you better understand the impact on your practice
Impact of HOPPS, ASC Payment Rule on GI
Nov. 16, 2015AGA developed summaries to help GI practices understand the effects of reimbursement changes from CMS.
Fast Approaching: CMS Deadline for Value-Based Modifier Program, PQRS Review
Nov. 10, 2015GIs in practices with 10 or more physicians need to review their 2014 Quality and Resource Use Reports by Nov. 23, 2015.
ICD-10 Implementation: So Far, So Good
Nov. 6, 2015Medscape provides an industry-wide update on ICD-10 implementation, and it's cautiously optimistic.
Colonoscopy: Screening or Surveillance?
Nov. 5, 2015If the patient is asymptomatic, GIs would like to know if it is a screening or surveillance colonoscopy, and how should it be coded.
AGA Works with CMS to Fix ICD-10 Screening Colonoscopy Error
Nov. 3, 2015AGA will continue working with the agency to ensure claims are processed correctly.
CMS Cuts Reimbursement to Colonoscopy
Nov. 2, 2015The cuts to the colonoscopy family of codes are inappropriately deep and slash payment for some procedures by more than 17 percent.
Administration Issues FAQ on Preventive Services Including Colonoscopy
Oct. 27, 2015AGA is pleased with the new FAQ guidance and will continue to advocate that a positive stool blood test be defined as part of the screening continuum.
Hepatitis B Vaccine Claims Denied in Error
Oct. 22, 2015A mass adjustment will be made to claims that were denied in error.
New ICD-10 FAQ: Excludes1 Note
Oct. 21, 2015Contradictory advice is causing confusion on how to use the note.
AGA Meets with CMS Regarding ICD-10 Issue
Oct. 21, 2015AGA will continue to work with CMS until a solution is implemented.
AGA Advocates HHS Expand Support of Quality Programs
Oct. 8, 2015Relevant measures are needed for quality reporting programs to be successful.
Lawmakers to CMS: Delay Stage III Meaningful Use
Oct. 5, 2015AGA supports the modification and delay of meaningful use requirements.
CMS Releases 2014 Quality and Resource Use Reports
Sept. 14, 2015GIs should request and review their reports to ensure accuracy.
AGA Submits Comment Letter to CMS
Sept. 10, 2015Comments provided by AGA, ACG and ASGE focused on the areas of payment policies and quality improvement.
Contact Congress to Support CRC Screening
Sept. 10, 2015Urge lawmakers to support maintaining access to CRC screening and reversing proposed Medicare cuts.
Population Health: Strategies for GIs to Survive and Thrive
Sept. 8, 2015The focus on population health will impact our reimbursement as we move from fee for service to value-based payments.
Ensure GI Voices are Heard
Sept. 2, 2015Sept. 8 is the last day to contact CMS regarding proposed cuts to colonoscopy procedures
Announcing the 2015 AGA Practice Management Survey
Sept. 1, 2015The survey will help guide AGA to better respond to the concerns of AGA membership and the entire gastroenterology industry.
CMS 'Grace Period' and Unspecified ICD-10 Codes
Aug. 31, 2015CMS clarifies that the grace period specificity is for codes submitted within the same category.
Key Ruling on Recovery of Medicare Overpayments
Aug. 18, 2015Providers need to monitor their Medicare and Medicaid payments to ensure they are correct.
Take Action: Contact Your Representative About Colorectal Cancer Screening
Aug. 18, 2015Urge Congress to support maintaining access to CRC screening and reverse proposed Medicare cuts.
Take Action Against Proposed Colonoscopy Cuts by Sept. 8
Aug. 13, 2015Help AGA make your voice heard regarding CMS-proposed cuts to colonoscopy and other lower GI endoscopy procedures.
AGA Takes Colonoscopy Cuts Poll Results to CMS
Aug. 5, 2015Colonoscopy procedures will be impacted by proposed CMS payment cuts.
GI Societies Fight CMS on Colonoscopy Pay Cuts
July 30, 2015AGA, along with our sister societies, is committed to fighting CMS-proposed cuts to colonoscopy for 2016.
Congressman Phil Roe to Serve as Keynote Speaker at GI Outlook 2015
July 28, 2015Don't miss the opportunity to hear Congressman Roe address health-care reform and the future of GI reimbursement.
Help AGA Increase Access to CRC Screening
July 22, 2015AGA advocates that Medicare patients shouldn’t be responsible for a co-pay or deductible for CRC screenings.
GI Outlook Conference to Examine Proposed Payment Changes
July 21, 2015Attend GI Outlook 2015 Aug. 7 to 9, for an in-depth look at the future of GI reimbursement.
AGA Lobbies Capitol Hill as Part of Alliance of Specialty Medicine Fly-In
July 16, 2015AGA members urged legislators to continue to oversee the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA).
Poll: How Will Colonoscopy Cuts Impact Your Practice?
July 15, 2015We want to share data on how cuts of up to 19 percent will affect GI practices.
Quality Measures in Gastroenterology
July 12, 2015There are 2 key government programs that largely shape current discussions on value-based health-care: PQRS and VBM.
Resolving HCV Treatment and Documentation Dilemmas
July 10, 2015This educational monograph reviews key drug interactions involving new direct-acting antiviral therapies, emphasizing the role of appropriate medication documentation to prevent errors and adverse events.
CMS Proposes Cuts to 2016 Colonoscopy Rates
July 9, 2015The proposed physician work values for the colonoscopy family are cut up to 19 percent.
Medicare Pay Rates: the Bad News and the Good News
July 7, 2015CMS proposes cuts to 2016 colonoscopy rates; base Medicare payments have increased by .5%.
House Votes to Repeal IPAB
June 24, 2015AGA supports the repeal of IPAB, which may disproportionately affect physicians through its Medicare spending decisions.
Poll: Do you Use Code 99490?
June 23, 2015AGA wants to know how many GIs are taking advantage of the Chronic Care Management code.
Physicians Should be Involved in the Political Process
June 8, 2015During DDW® 2015, Dr. Gaurav Singhvi attended a session on the political process and came away with an understanding of how important it is for physicians to be involved.
Enroll in PQRS to Avoid Payment Reductions
June 1, 2015GI practices with two or more eligible professionals must participate in PQRS 2015 in order to avoid payment penalties in 2017.
Deadline Approaching: EHR Incentive Program
June 1, 2015Eligible professionals who did not participate in the 2014 EHR Incentive Program may face a negative payment adjustment in 2016 if they do not submit hardship exception applications.
Extra Effort Will Move Medicine Forward, John Allen Says at Joint Presidential Plenary
May 19, 2015Highlights from the annual AGA/ASGE Joint Presidential Plenary at DDW® 2015.
Anesthesia Covered as Part of Screening Colonoscopy
May 11, 2015According to a new HHS guidance, non-Medicare patients are not responsible for the cost of anesthesia services during screening colonoscopies.
Congress Approves Joint Budget Agreement
May 6, 2015A budget resolution passed by Congress would balance the budget and cut $5 trillion in spending, some from mandatory spending programs.
CMS Releases Provider-Level Prescribing Data
May 5, 2015Recently released data on the Medicare Part D prescription drug program allows the general public to search for their health-care provider's prescribing habits.
What Does the New Congress Mean for GI?
May 4, 2015The House Speaker promised, “… at some point, we’ll move to replace Obamacare.”
GI Outlook 2015: The Practice Management Conference
May 4, 2015Don’t miss the opportunity to attend this August 2015 practice management conference in Chicago, IL.
Physician Members of Congress to Speak at DDW®
May 1, 2015Reps. Raul Ruiz and Phil Roe will discuss personal experiences, importance of having physicians in Congress during morning session.
CMS Allows MACs to Change Coding on Physician Claims
April 29, 2015GIs need to be aware that CMS is allowing Medicare Administrative Contractors to revise code claims and adjust payments, if medical records support a change.
AGA Attends SGR Repeal Celebration at the White House
April 22, 2015AGA Institute co-executive vice president, Lynn Robinson, was honored to represent AGA at the historic event
Goodbye SGR, Hello Value-Based Reimbursement
April 16, 2015The SGR repeal has passed Congress and is expected to be signed into law by the president.
CMS Provides Additional Information on Modifiers
April 15, 2015While CMS develops instructions for using the X modifiers, the agency advised continued use of the 59 modifier.
CMS Proposes New Rules for the EHR Incentive Program Stage 3
April 9, 2015Newly proposed rules will impact reimbursement levels based on participation.
Understanding How to Report for PQRS and Value-Based Payments
April 2, 2015A new AGA brochure will help GIs understand and prepare for reporting to the PQRS and the Value-Based Modifier Program. All physicians are required to report to these programs beginning in 2015.
SGR Repeal Legislation Awaits Senate Action
April 2, 2015The House passed SGR repeal legislation, but the Senate failed to vote prior to leaving for the spring recess. There's still time to tell your Senators that you support the bill.
CMS Makes Mass Adjustment of Obesity Therapy Claims for G0473
April 2, 2015If you treat obesity with behavioral therapy, you need to be aware that the systems error that's preventing the co-insurance and deductible from being waived will be fixed by April 6.
House Overwhelmingly Approves SGR Repeal Legislation
March 26, 2015SGR repeal legislation has overwhelmingly passed the House of Representatives. However, the Senate still needs to vote on the bill or another patch will be enacted. Tell the Senate to repeal the SGR today.
Keeping the Small GI Practice Alive: Five Lessons Learned
March 26, 2015The numerous federal programs in which health-care professionals need to participate uniquely affect small GI practices.
GI Outlook 2015: The Practice Management Conference
March 26, 2015Don’t miss this opportunity to gain the necessary tools and strategies to help your practice adjust and ultimately thrive in a changing health-care environment.
Congressional Leaders Close on Bipartisan SGR Repeal Deal
March 19, 2015Congress might be close to passing legislation that will repeal the sustainable growth rate formula, which determines Medicare reimbursements rates. AGA, and the entire medical community, supports this legislation. Congress needs to hear from practicing gastroenterologists who support the legislation, too.
United Healthcare Pilot Laboratory Pre-notification Program Impacts Florida GIs
March 12, 2015GIs in Florida who work with UnitedHealthcare will be required to submit pre-notification for nearly 80 different lab tests.
Prepare for ICD-10 with End-to-End Testing in July
March 12, 2015The conversion to ICD-10 is scheduled for Oct. 1, 2015. Begin preparing for the upcoming acknowledgement testing, which has to be completed before implementation.
Removing Barriers to Colorectal Cancer Screening Legislation Introduced
March 12, 2015AGA has long advocated for Medicare to waive co-insurance for patients whose colonoscopy becomes therapeutic and supports new legislation on this effort.
CMS Reminds Providers of Upcoming EHR Deadline
March 5, 2015The deadline to attest for meaningful use has been extended to March 20. Health-care providers must attest to demonstrate meaningful use for 2014 in order to avoid payment reductions beginning in 2016.
What Employment Model is Best for You?
March 5, 2015If you're looking to make a change in your career, you might have questions about which employment model is best for you. Presenters on an upcoming AGA webinar will discuss their decision-making process when choosing which employment model worked best for them, as well as answer your questions.
No Association Between Centers for Medicare and Medicaid Services Payments and Volume of Medicare Beneficiaries or Per-Capita Health Care Costs for Each State
March 1, 2015We investigated regional variations in payments to gastroenterologists and evaluated whether payments correlated with the number of Medicare patients in each state.
AGA President Visits Capitol Hill
Feb. 26, 2015John I. Allen, MD, MBA, AGAF, AGA Institute president, was on Capitol Hill meeting with key legislators and AGA allies to discuss issues of importance of GI and thanking them for their ongoing support. Throughout the day, Dr. Allen’s discussions focused on issues related to physician payment reform, NIH research, patient access to life-saving treatments and colonoscopy Medicare co-insurance. Read more on the AGA policy blog.
AGA President Visits Capitol Hill
Feb. 26, 2015John I. Allen, MD, MBA, AGAF, AGA Institute president, was on Capitol Hill this week meeting with key legislators and AGA allies to discuss issues related to physician payment reform, NIH research, patient access to life-saving treatments and colonoscopy Medicare co-insurance.
Join AGA in Raising CRC Awareness This March
Feb. 26, 2015AGA is committed to raising awareness and increasing screening rates for colorectal cancer. For Colorectal Cancer Awareness Month, there are a number of ways you can join us to help make it happen.
Preparing for Potential GI Payment Cuts: 3 Quick Tips
Feb. 19, 2015Shivan Mehta, MD, MBA, and Dawn L. Francis, MD, offer three vital ways in which to prepare for potential cuts to reimbursement and mitigate any effect they may have.
Cuts to Lower Endoscopy Codes Delayed; AGA PAC Plays Key Role
Feb. 16, 2015
CMS Reminds Providers of Upcoming EHR Deadline
Feb. 12, 2015The deadline to attest for 2014 meaningful use requirements is quickly approaching.
White House Delivers 2016 Budget Proposal to Congress
Feb. 12, 2015President Obama's fiscal year 2016 budget proposal contains many provisions that will impact the practice and science of medicine.
How to Make Peace With Your EHR
Feb. 5, 2015Consistent adherence to these three suggestions will give you five more minutes to actually enjoy your time with your patient.
2015 AGA Tech Summit: Early Registration Ends Feb. 6
Feb. 5, 2015Save $200 when you register for the AGA Tech Summit by Friday, Feb. 6, 2015.
Humana Updates AGA on Coding Plans
Jan. 29, 2015To help members manage their practices and reimbursements, AGA has been contacting payors nationwide to determine how their providers should code procedures correctly. Most recently, AGA has received an update from Humana.
Jan. 10, 2015AAPC's GI coding experts answer challenging coding questions related to upper EUS with FNA and what code range to use when the non-admitting physician sees a Medicare patient.
How to Ensure No Money Is Left on the Table
Jan. 9, 2015Barbara Tauscher, MHA, FACMPE, provides insight into the revenue cycle management (RCM) process and its components. She explains that it will be critical for GI practices to ensure a successful and efficient RCM process to reduce any possibility that there’s “money left on the table.”
Coding Surprises in 2015
Jan. 9, 2015The new year brings significant changes to coding for lower GI endoscopic procedures in CPT 2015, as well as the formation of temporary G-codes.
Tips to Help You Maximize Revenue
Jan. 9, 2015When it comes to ensuring ongoing financial success, where are you devoting your focus? AGA is here to help with advice on areas that offer opportunities to improve the financial health of your practice. Rajeev Jain, MD, AGAF, chair of the AGA Institute Practice Management & Economics Committe, explains.
Payor Contract Negotiation: What You Need to Know to Prepare for Medicare Cuts
Jan. 9, 2015Across the country, the majority of commercial payors base their rates for GI services on Medicare rates. Vance Rodgers, MD, AGAF, explains that there are steps you can take right now to negotiate payor contracts to ensure you are in the best position possible should Medicare rates for colonoscopy decline in 2016.
2014 PQRS Deadline Fast Approaching
Jan. 9, 2015The deadline to submit data for the CMS Physician Quality Reporting System (PQRS) is March 15, 2015. AGA’s Digestive Health Recognition Program™ can help you meet PQRS reporting requirements and deadlines.
GI Societies Comment on Final Rules
Jan. 8, 2015The GI societies submitted comments to CMS on several issues discussed in the 2015 Medicare Physician Fee Schedule and Ambulatory Surgical Center/Outpatient Prospective Payment Systems Final Rules, including moderate sedation and the Open Payments program.
Top New Year’s Resolutions for Your Practice
Jan. 8, 2015Most people make personal New Year's resolutions, but did you know that you should make them for your practice, as well? AGA members Drs. Rajeev Jain and Joel Brill outline seven resolutions to help ensure the viability of your practice for 2015.
Payors Share Their Plans to Recognize 2015 GI CPT and G-Codes With AGA
Dec. 18, 2014Since CMS delayed revaluing the colonoscopy codes, the agency developed several temporary G-codes for use with Medicare beneficiaries. However, there has been uncertainty about whether commercial payors will recognize these new codes.
Pay Careful Attention to Colonoscopy Indication
Dec. 11, 2014When choosing the correct colonoscopy indication for the care of patients, GIs need to be aware of the implications of their choices. An inaccurate determination can effect everything from clinical care to clinical research.
ACOs: An Opportunity for GIs
Dec. 4, 2014Have you ever wondered what accountable care organizations (ACOs) really are, and what they mean for GIs? According to an article by G. Anton Decker, MBBCh, MRCP, FACG, CPE, MHA, in Clinical Gastroenterology and Hepatology, ACOs provide an opportunity for GIs, their practices and medical societies to proactively set quality standards and develop bundled payment options.
Insider's Perspective on the Medicare Final Rule
Nov. 6, 2014AGA Institute President Dr. John Allen reflects on the recent CMS announcement that it is delaying cuts to colonoscopy under Medicare. This success is the culmination of a year's worth of intense effort to work with CMS and Congress to change the process by which medical procedures are valued for reimbursement.
2015 Medicare Pay Rules Delay Cuts to Lower GI Codes
Nov. 4, 2014In the Medicare Physician Fee Schedule Final Rule, CMS delayed valuing colonoscopy codes, as requested by the GI societies. Additionally, for 2015, CMS reduced some of the cuts that had been made to upper GI codes in the 2014 final rule.
AGA DHRP™ Offers Program to Qualify for CMS PQRS
Oct. 30, 2014The AGA Digestive Health Recognition Program™ (DHRP) is a CMS-qualified data registry that offers clinicians a platform to demonstrate and be recognized for superior quality of care in the treatment of IBD, hepatitis C and CRC screening and surveillance.
CMS Urges Physicians, Practice Groups to Review Quality and Cost Reports
Oct. 30, 2014Physicians and large provider groups are encouraged to obtain and review their Quality and Resource Use Reports. The data contained in the 2013 reports will be used to determine potential changes in your 2015 reimbursement.
Gastroenterologists Advocate for GI on Capitol Hill
Oct. 24, 2014
AGA members visited Capitol Hill and gained insight on how AGA's advocates on are working to help GI and specialty medicine. These face to face meetings help educate lawmakers about issues that will affect your practice of medicine.
Rep. Bill Cassidy, R-LA, Fights to Join the Senate
Oct. 24, 2014
One of AGA's most stalwart champions on Capitol Hill, Rep. Bill Cassidy, R-LA, is in a tight race to join the Senate. As the only gastroenterologist in Congress, Rep. Cassidy fights for GI and physicians issues.
Pricing Practices of Gastroenterologists
Oct. 23, 2014There is growing awareness of the price disparities for equivalent services in health care. According to new research in Clinical Gastroenterology and Hepatology, in New York City, the most expensive gastroenterologist charges 14-fold more than the least expensive.
How Does a Gastroenterologist Demonstrate Value?
Oct. 23, 2014In the October journals' AGA Governing Board update, Dr. Lawrence Kosinski discusses the importance of demonstrating value in the practice of medicine. According to Dr. Kosinski, GIs are uniquely positioned to manage the outcomes of their patient populations.
AGA Continues to Press for Fix on Screening Colonoscopy Cost-Sharing
Oct. 20, 2014
Since the enactment of the Affordable Care Act (ACA), the AGA, along with and our sister societies, has been pushing for a fix to the current policy that imposes coinsurance on Medicare beneficiaries whose screening colonoscopy becomes therapeutic and/or requires polyp removal.
Spotlight on Illinois Gastroenterology Group
Oct. 16, 2014Illinois Gastroenterology Group, which is comprised of several AGA members, has entered into a partnership with Blue Cross and Blue Shield of Illinois to create the first specialty intensive medical home program in the state to care for high-risk Crohn's disease patients.
CMS Updates Instructions for Submitting Requests to Reopen Claims
Oct. 3, 2014CMS, in an effort to streamline and standardize the requesting process, has petitioned the National Uniform Billing Committee for a “new” bill type frequency code that can be used by gastroenterologists to indicate a request for reopening and a series of condition codes that can be utilized to identify the type of reopening being requested.
Transparency Was Top Priority for Advocacy Day
Oct. 3, 2014AGA members visited Capitol Hill on Sept. 19 to send a clear message to Congress that impending changes in health care will jeopardize both the science and practice of gastroenterology.
AGA Asks CMS to Clarify Colonoscopy Cost-Sharing Requirements
Sept. 18, 2014AGA has requested that CMS clarify that a colonoscopy resulting from a positive fecal occult blood test or fecal immunochemical test is part of a continuum of care for colorectal cancer screening. Therefore, patients should not be charged for the screening colonoscopy.
Spend Your Time on Patient Care, Not on Compliance
Sept. 18, 2014The transition to ICD-10 requires significant changes for every health-care payor and provider. The AGA Institute has collaborated with leading organizations to provide you with various resources to help ensure a smooth transition.
Group Practices: Register for PQRS by Sept. 30
Sept. 11, 2014Registration for the CMS Physician Quality Reporting System (PQRS) group practice reporting option ends Sept. 30, 2014.
Clinical Problem-Solving Techniques and Strategies for Today's Practitioner
Sept. 4, 2014The 2015 AGA Clinical Congress is a one-stop solution for practicing clinicians. Top leaders in the field will come together to share strategies and techniques for improving the quality of patient care and help health-care providers demonstrate their value.
Avoid CMS PQRS Penalties by Using the AGA Digestive Health Recognition Program
Sept. 2, 2014
Take Action: Contact CMS re: Upper and Lower Endoscopy Valuation & Reimbursement
Aug. 28, 2014We thank the nearly 400 practicing gastroenterologists from around the U.S. who have already submitted comment letters to CMS. However, we still need your help to make sure that the voice of GIs throughout the country is heard. Send comments on the proposed fee schedule rule to CMS by Sept. 2.
Have You Enrolled in DHRP?
Aug. 21, 2014The AGA Digestive Health Recognition Program™ (DHRP) is a CMS qualified data registry that offers clinicians a platform to demonstrate and be recognized for superior quality of care in the treatment of IBD, hepatitis C and colorectal cancer screening and surveillance.
Colonoscopy Bundle vs. Medicare Payment Model
Aug. 14, 2014AGA clarifies some recent confusion about the differences between bundled payments and the Medicare review of physician work and reimbursement for colonoscopy procedures.
Cutting the Wrong Test at the Wrong Time
Aug. 14, 2014Cutting reimbursements rates for colonoscopy would risk short-term gains in exchange for longer-term liabilities in terms of lives lost and costs to the U.S. health-care system, argues AGA Institute President John I. Allen and his colleagues at ACG and ASGE.
It’s Official – ICD-10 Delayed Until Oct. 2015
Aug. 7, 2014AGA offers resources to help your practice prepare for this change.
Mystified by how the Medicare Reimbursement System Works? Read on.
Aug. 7, 2014The reimbursement process begins outside of the government system, and so does AGA’s work on your behalf. The AGA/Specialty Society Relative Value Scale Update Committee plays a significant role in identifying the physician work and resources needed to provide services, which impacts reimbursement by Medicare, Medicaid and commercial payors.
Medicare Value-Based Payment Modifier on the Horizon
July 11, 2014Officials at CMS are working to implement changes to the Medicare physician fee schedule that will tie payment rates to quality and cost measures for physicians and physician groups. The value-based payment modifier will be phased-in starting next year and could result in a 2 percent reduction of Medicare payments for all eligible professionals.
UnitedHealthcare Multiple Procedures Policy Changes to Impact GIs
July 11, 2014Beginning in the third quarter this year, UnitedHealthcare will change its multiple procedure policies for its Medicare Advantage, Commercial and Community Plan lines of business to align with CMS’s multiple endoscopy payment rules.
Value-Based Reimbursement Changes GI’s Primary Revenue Stream
July 10, 2014As we shift from volume-based reimbursement to value-based payment for colorectal cancer screening and other GI procedures, physician-led groups find themselves in a strong position to provide the greatest improvements in clinical care and in health-care value.
AGA Leaders Participate in Alliance of Specialty Medicine Fly-In
July 10, 2014AGA physicians J. Sumner Bell, MD, Joel V. Brill, MD, Carla Ginsburg, MD, Peter Margolis, MD, Rajeev Jain, MD, and Ronald Fogel, MD, (pictured at left) were in Washington this week to represent gastroenterology at the Alliance of Specialty Medicine annual legislative fly-in.
2015 Medicare Payment Proposals Are Out
July 10, 2014Despite aggressive advocacy by AGA, ACG and ASGE, CMS did not include anticipated changes to payments for lower endoscopy, including colonoscopy, in the proposed rule for payments that begin on Jan. 1, 2015.
Medicare Proposed Rules Tri-Society Email - July 2014
July 8, 2014
CMS to Hold ASC Quality Reporting Webinar
July 3, 2014CMS is holding a webinar to discuss new and amended requirements that are anticipated for ambulatory surgery centers (ASCs) in the upcoming payment rules for 2015.
Medicare Contractor Releases Statement on Special Stains for GI Endoscopy
July 3, 2014A Medicare administrative contractor, Palmetto GBA, has released a statement on standards for evaluation of GI endoscopy specimens.
Lingering Reimbursement Concerns About Recent Advances
July 3, 2014Over the last year, innovation in GI technology has surged forward. Pivotal studies bring new devices toward clinical adoption, but reimbursement issues can impede clinical progress.
Measure and Demonstrate Improved Patient Health Outcomes
July 2, 2014The AGA Digestive Health Recognition Program™ now includes a colorectal cancer screening and prevention module. Now there are three disease states available to help you qualify for BTE Recognition, avoid CMS penalties and earn ABIM maintenance of certification points.
AMA Passes GI Resolution on Transparency
June 19, 2014The AMA House of Delegates has passed a resolution in support of the GI societies' campaign calling for increased transparency, participation and accountability in the CMS payment determination process.
Reimbursement, Thriving in the Age of Accountable Care and More
June 19, 2014AGA President John I. Allen, MD, AGAF, spoke with Becker's ASC Review to answer questions about his goals as president and the best opportunities for practicing GI physician success.
New! AGA Introduces DHRP Modules for CRC Screening and Prevention
June 19, 2014The AGA Digestive Health Recognition Program™ (DHRP) now includes a colorectal cancer (CRC) screening and prevention module, as well as modules for IBD and HCV care.
GI Outlook 2014: Early Bird Deadline is June 20
June 12, 2014Attend the GI Outlook 2014 Conference to hear firsthand from experts in the field of GI practice management and prepare yourself for the coming changes that will have a significant impact on your practice.
Virtual Credit Card Payments from Health Plans
June 12, 2014Virtual credit cards are becoming more popular with payors; however, physicians must be aware of the associated transaction fees.
Lingering Reimbursement Concerns About Recent Advances
June 6, 2014Over the last year, innovation in GI technology has surged forward. Pivotal studies bring new devices toward clinical adoption, but reimbursement issues can impede clinical progress.
Innovation to Improve Patient Outcomes
June 6, 2014The hurdles to clinical innovation have changed, as payors demand long-term safety, efficacy and economic data to justify reimbursement. The new question for device makers to answer is “how can I innovate in a meaningful way to improve outcomes?”
Value-Based Reimbursement Changes GI’s Primary Revenue Stream
June 6, 2014As we shift from volume-based reimbursement to value-based payment for colorectal cancer screening and other GI procedures, physician-led groups find themselves in a strong position to provide the greatest improvements in clinical care and in health-care value.
AGA Center Answers Current GI Challenges, Unmet Needs
June 6, 2014The AGA Center for GI Innovation and Technology brings together industry, investors, inventors and AGA members to advance new technologies in GI and ultimately improve the care of patients with disorders of the digestive tract.
A Productive Day in Washington, DC
June 5, 2014AGA Institute President, John I. Allen, MD, MBA, AGAF, recently traveled to Washington, DC, to meet with regulators and lawmakers. He updated them on the tremendous impact of colorectal cancer screening on saving lives, as well AGA's work on behalf of gastroenterology.
Political Leaders Need to Hear the Voice of GI
June 5, 2014AGA member, Joel R. Judah, MD, a member of the AGA PAC Board of Advisors, recently met with Rep. Tom Price, R-GA, to discuss the personal impact that the recent Medicare cuts to upper GI endoscopy services were having on him and his practice.
Write to Your Senators: Tell CMS that Medical Practices Need Transparency
June 5, 2014The GI societies are disputing the validity of the cuts made to upper GI endoscopy services in the 2014 Medicare final rule. Now, colonoscopy services are at risk for reimbursement reductions. Contact your U.S. Senator so your voice is heard calling upon CMS for more transparency in the Medicare process.
GIs Lead Charge for More Transparency in Medicare Rate-Setting Process
May 29, 2014
GI Societies Discuss Colonoscopy Reimbursement with CMS Administrator
May 22, 2014The presidents of AGA, ACG and ASGE met today with the administrator of CMS, Marilyn Tavenner, (pictured at left) to discuss key points related to colonoscopy. Together, the three GI societies have joined forces to engage federal policymakers and push for increased transparency in the Medicare reimbursement rate-setting process.
Hear From the Experts As They Address Critical Changes in GI Practice Management
May 15, 2014Attend the GI Outlook 2014 Conference to hear firsthand from experts in the field of GI practice management and prepare yourself for the coming changes that will have a significant impact on your practice.
CMS Sets New ICD-10 Compliance Date, Cancels July Testing
May 15, 2014CMS announced the new deadline for ICD-10 implementation will be Oct. 1, 2015.
AGA Digestive Health Recognition Program™ Receives CMS QCDR Approval
May 1, 2014CMS approved the new colorectal cancer screening and surveillance module of the AGA Digestive Health Recognition Program™ as a qualified clinical data registry (QCDR).
GI Societies Meet with CMS to Discuss Reimbursement
April 24, 2014AGA, ACG and ASGE have been working together on a campaign for fair GI reimbursement. CMS has cut reimbursement for upper GI endoscopy codes and the stakes are even higher as CMS prepares to review lower GI codes for 2015 reimbursement.
CMS Releases Physician-Level Medicare Data
April 24, 2014CMS has released Medicare claims data for physicians who participated in the program in 2012. The data will make it possible to identify payment received by individual health-care providers and to conduct a wide range of analyses comparing different services and procedures.
Free Webinar: Exploring Bundled Payment Models for Colonoscopy
April 10, 2014Join AGA for a free webinar on AGA's recently developed payment framework for colonoscopy performed for colorectal cancer screening or surveillance. The webinar will take place Thursday, April 17, from noon to 1 p.m. ET.
Contact Your Representative: Transparency Needed at CMS
April 10, 2014AGA is working with our allies on Capitol Hill to sign onto a letter to CMS encouraging more transparency in their process for assigning value to procedures. The deadline for representatives to sign the letter is Friday, April 11. We need your help to tell your legislator that you support this issue.
New Colonoscopy Category II Codes
April 4, 2014As of April 1, CPT code 3775F should be used if adenomas or other neoplasms are detected during screening colonscopy and 3776F should be reported if they are not detected.
Improper eRx Payments Under CMS Scrutiny
April 4, 2014CMS will launch a four-year initiative to recover improper payments made through its Physician Quality Reporting System and the Electronic Prescribing (eRx) Incentive Program.
2013 Final Year for eRx Incentive Program
April 4, 2014Although 2013 was the last year for participating and reporting in the Medicare Electronic Prescribing (eRx) Incentive Program, content will remain available online so participants can access materials associated with the eRx payment, payment adjustment and feedback reports.
Improving Clinical Documentation for ICD-10
April 4, 2014Your reimbursement with ICD-10 will depend on the level of specificity you provide. Take some time to focus on clinical documentation improvement — it will help your practice prepare for the new codes and maximize efficiency and reimbursement.
How to Handle a Meaningful Use Audit
April 4, 2014By Lawrence Kosinski, MD, MBA, AGAF, and Sara H. Shanti, JD
HHS intends to audit approximately 5 to 10 percent of all eligible providers who attested for meaningful use to confirm the security of certified EHR technology. These steps will help you prepare for an audit and provide a meaningful response.
GI Outlook 2014: The Practice Management Conference
April 3, 2014Don’t miss this opportunity to hear firsthand from experts in the field of GI practice management and prepare yourself for the coming changes affecting your practice.
President Obama Signs One-Year SGR Patch Legislation
April 3, 2014AGA is extremely disappointed that Congress passed a patch since we were so close to finally enacting a permanent solution to the sustainable growth rate (SGR).
NEW! A GI Coding Tool That Pays for Itself at Just $99.95/Year Now Through May 30
April 3, 2014The GI Coding Advisor, a Web-based coding tool, offers GI practices an easy and inexpensive way to maximize reimbursements, scrub claims, effectively appeal wrongfully denied claims and transition to ICD-10.
Bundled Payments Come to Gastroenterology
March 27, 2014AGA has developed a bundled payment model framework for colonoscopy for colorectal cancer screening, diagnosis and surveillance. By developing a framework and educating GIs about value-based reimbursement, AGA hopes to inform physicians who wish to consider contracting with payors, purchasers and risk-bearing organizations around new payment models.
Take Action: Demand Transparency from CMS
March 20, 2014AGA, ACG and ASGE are disputing the validity of the 2014 Medicare reimbursement rates for upper GI endoscopy services. The GI societies have engaged the help of Congress to avoid future eleventh hour changes to our reimbursement. Colonoscopy codes are currently under review for 2015, so the stakes are high.
AGA Attends Special White House Tour
March 20, 2014AGA members attended a special White House tour to commemorate National Colorectal Cancer Awareness Month. The president issued a proclamation that highlights the importance of screening to help combat colorectal cancer.
Still Time to Register for the 2014 AGA Tech Summit
March 13, 2014Register today to secure your place at the 2014 AGA Technology Summit. A prominent faculty of leaders from the physician, med tech, regulatory and investor communities has been assembled to closely examine the driving forces behind the commercialization of GI technologies.
Is Your Practice Operating at Optimal Efficiency?
March 6, 2014New seminars and audio conferences address the most pertinent reimbursement, coding and compliance issues to help enhance the efficiency of your practice.
GI Societies Partner on Initiative for CRC Screening and Hill Briefing
March 6, 2014The gastroenterology societies have joined together on a new initiative to highlight the potential of colonoscopy to save lives — The Value of Colonoscopy: Saving Lives Through Expert Care. The partnership was first announced during a Capitol Hill briefing which utilized scientific data to showcase the potential life-saving value of colonoscopy and the unique skills and qualifications of gastroenterologists.
Call On Congress to Fix the SGR Once and For All
March 6, 2014AGA is collaborating with our allies in the Alliance of Specialty Medicine in setting up a hotline and urges you to call your representatives and senators to urge them to cosponsor and pass the SGR Repeal and Medicare Provider Payment Modernization Act (H.R. 4015/S. 2000).
New Feature on Gastro.org! AGA Quality Improvement Timeline
Feb. 20, 2014There are a myriad of federal quality improvement programs that will affect physician reimbursement beginning in 2014. Keeping track of all the changing regulations and deadlines is mind boggling. That’s why AGA developed a new tool — the AGA Quality Improvement Timeline.
SGR Repeal Compromise Legislation Introduced
Feb. 20, 2014Legislation to repeal the sustainable growth rate formula is moving forward in Congress. AGA urges Congress to enact the legislation before the temporary physician patch expires at the end of March.
Dr. Rustgi Travels to Capitol Hill
Feb. 20, 2014AGA President, Anil Rustgi, MD, AGAF, met with lawmakers on Capitol Hill. During his eight congressional visits, Dr. Rustgi discussed topics of importance to AGA and gastroenterology.
Impact of Changing Policies on Physician Reimbursement
Feb. 10, 2014Learn about new health-care policies (PQRS, meaningful use, the value-based payment modifier) that will impact your practice and physician reimbursement.
GI Societies Fighting Medicare Cuts
Feb. 6, 2014On Jan. 27, the GI societies submitted joint comment letters for the 2014 Medicare Physician Fee Schedule and the 2014 Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System Final Rules.
Which ICD-10 Codes Will Your Practice Use Starting Oct. 1?
Feb. 6, 2014By Oct. 1, 2014, your practice must start using ICD-10 codes for services provided on or after Oct. 1. To help with the transition, AGA has collected the top 50 diagnostic GI codes and translated them for you in alphabetical and numerical order.
Get a Few More Weeks to Submit for PQRS By Enrolling in AGA DHRP
Jan. 30, 2014CMS ruled that providers not successfully participating in the Physician Quality Reporting System (PQRS) by the 2013 reporting period will have their Medicare reimbursement decreased by 1.5 percent in 2015 and 2 percent in 2016. Practices using the AGA Digestive Health Recognition Program™ (DHRP) have a two-week extended deadline to submit data via EHR or claims-based reporting.
Early Registration Deadline for the 2014 AGA Tech Summit Approaching
Jan. 30, 2014Key stakeholders in the development and delivery of new GI technologies will converge on San Francisco to address critical elements that impact the likelihood of success in the marketplace.
Important Payment Adjustment Information for Medicare EPs
Jan. 16, 2014Eligible professionals (EPs) participating in the Medicare EHR Incentive Program may be subject to payment adjustments beginning on Jan. 1, 2015. CMS will determine the payment adjustment based on meaningful use data submitted prior to the 2015 calendar year.
How to Manage ACO Exclusivity Requirements
Jan. 10, 2014Dr. Lawrence R. Kosinski sheds some light on how GI groups can navigate the exclusivity requirements when providing services to multiple accountable care organizations (ACOs), while also preserving Physician Quality Reporting System participation.
Implementation Delay in Two ASC GI Measures
Jan. 9, 2014CMS has notified ambulatory surgical center (ASC) facilities that the implementation of two chart-abstracted measures for colonoscopy surveillance has been delayed. Data collection will now commence with April 1, 2014, encounters.
Present Your New Medical Technology at the 2014 AGA Technology Summit
Jan. 9, 2014Receive valuable feedback from a panel of industry and regulatory leaders on commercializing your GI medical technology.
Quality Provisions in the 2014 Medicare PFS Final Rule
Dec. 19, 2013The 2014 Medicare Physician Fee Schedule Final Rule contains changes to quality programs that will affect gastroenterologists. AGA has prepared an analysis highlighting the important changes.
What GIs Need to Know About Patient Surveys
Dec. 19, 2013The use of patient surveys is going to become more widespread as reimbursement moves away from fee-for-service. Gastroenterologists need to understand how to use these surveys to enhance patient care and maintain reimbursement.
Inaugural AGA Partners in Quality Meeting to Be Held Jan. 16 in Miami Beach, FL
Dec. 19, 2013The inaugural AGA Partners in Quality Meeting is scheduled for Thursday, Jan. 16, 2014, in Miami Beach, FL. Key stakeholders in the GI and hepatology community will meet to discuss how AGA can help gastroenterologists identify and negotiate the upcoming trends in health care and to develop business models to address these changes.
Colonoscopy and the Self-Insured Employer
Dec. 19, 2013Peter S. Margolis, MD, member of the AGA Institute Practice Management & Economics Committee, explains how a bundled payment model for colon cancer screening would work and provides questions to ask before negotiating a bundle.
Senate Passes Budget Agreement with Three-Month SGR Fix
Dec. 19, 2013The Senate passed both the Bipartisan Budget Act of 2013 and Pathway for SGR Reform Act of 2013, which the President is expected to sign into law. The House passed a bipartisan budget agreement, which includes a three-month SGR patch that prevents the 24 percent Medicare physician payment cut from being implemented.
CMS to Deny Claims When Ordering/Referring Provider Not Enrolled in Medicare
Dec. 12, 2013CMS will implement edits on providers ordering/referring Part B, durable medical equipment and Part A home health agency claims effective Jan. 6, 2014.
Important Reimbursement News
Dec. 12, 2013There are currently several moving legislative pieces and regulatory decisions affecting physician reimbursement.
Physicians Discuss Lowering Health-Care Costs
Dec. 6, 2013The Robert Wood Johnson Foundation recently gathered a panel of 18 physicians to discuss their suggestions for curbing health-care costs. As AGA continues to develop tools and resources to help GIs succeed during this challenging time, we are encouraged to see that health leaders across specialties have similar perspectives on how to improve quality and reduce costs.
You Can Still Save on Your 2014 Clinical Congress Registration
Dec. 5, 2013Register today to save on your 2014 Clinical Congress Registration. Physician attendees can earn up to 8 MOC points for attending the congress.
Support and Stimulate the Development and Delivery of New GI Technologies
Dec. 5, 2013Lend your voice to the discussion on advancing GI practice through innovation. Key stakeholders in the development and delivery of new GI technologies will converge on San Francisco to address critical elements that impact the likelihood of success in the marketplace.
CMS Cuts 2014 Medicare Reimbursement Rates
Dec. 5, 2013The 2014 pay rates include significant cuts for gastroenterology, primarily in the endoscopy family codes. AGA members and leadership are questioning the rationale for the cuts as the methodology is unclear. We are exploring all options to appeal and mitigate these reductions, which are untenable and may reduce access to care.
Prepare for ICD-10 with a Free Webinar on Friday, Dec. 13
Dec. 5, 2013Join Dr. Lawrence R. Kosinski and Rhonda Buckhotlz for a free, live webinar on The Impacts of ICD-10 on Friday, Dec. 13, from noon to 1 p.m. ET. A Q&A session will be included.
AGA Tech Summit Program Features GI Surgeon Perspective on Innovation through Collaboration with SAGES
Nov. 21, 2013AGA Tech Summit organizers teamed with Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) to lend GI surgeon perspective on innovation to the 2014 program.
Still Time to Register for the AGA-FDA Regulatory Workshop
Nov. 21, 2013Do not miss the opportunity to have your voice heard and make a direct impact on new GI technologies. Spread the word to your colleagues and inform them their input is needed and valued as well.
Measure and Demonstrate Improved Patient Health
Nov. 21, 2013The AGA Digestive Health Recognition Program™ (DHRP) is now open to report on 2013 IBD and hepatitis C data. The program enables you to demonstrate quality and gain Bridges to Excellence recognition, avoid CMS Physician Quality Reporting System penalties, and complete Maintenance of Certification requirements.
AGA to Congress: Fix the Broken Payment System
Nov. 14, 2013
Fixing the broken Medicare physician payment system has long been a high priority for AGA, and we’re hopeful that, between now and the end of the year, we have the best chance to date to get permanent reform.
AGA has provided the Senate Finance Committee and the House Ways and Means Committee with feedback on their recent draft proposal to repeal the sustainable growth rate formula, which dictates reimbursement.
AMA/RUC Surveys Underway
Nov. 14, 2013The next round of AMA/Specialty Society Relative Value Update Committee (RUC) surveys regarding the valuation of physician work for colonoscopy, colonscopy through stoma and endoscopic ultrasound procedures will close on Nov. 21. Your participation is critical to ensuring that GI procedures are valued accurately and fairly.
Proposal Repeals SGR, Transitions Physicians to Value-Based System
Nov. 7, 2013The Senate Finance Committee and the House Ways and Means Committee released a discussion draft on their proposal that repeals the SGR and creates a framework to transition physicians to a more value-based system.
Program Year 2012 QRURs for Group Practices Are Available
Nov. 7, 2013CMS is offering group practices of 25 or more the opportunity to see how the value-based modifier will be applied to them in future years with access to the Program Year 2012 Quality and Resource Use Reports (QRURs).
ICD-10 Webinar Scheduled for Dec. 13
Oct. 31, 2013All gastroenterology practices and ASCs must transition to the use of ICD-10 codes by the HHS mandated deadline of Oct. 1, 2014. Join us for a webinar on Dec. 13, at noon ET, to receive actionable tips to help with the transition.
AGA Offers Upper GI Endoscopy Coding Reference Guide for 2014
Oct. 24, 2013AGA has developed a Reference Guide to Upper GI Endoscopy Coding for changes to the 2014 CPT® (Current Procedural Terminology) codes. This reference provides an overview of the changes, including a crosswalk from old to new codes.
How to Work with Your Lawmakers
Oct. 23, 2013The field of gastroenterology is facing some serious threats. AGA has the tools to help you to connect with your legislators on issues of importance to GI in your community.
AGA DHRP Now Open to Report on Hepatitis C and IBD Data
Oct. 17, 2013The AGA Digestive Health Recognition Program™ (DHRP) is now open to report on 2013 hepatitis C and IBD data. The DHRP was developed by AGA to make it easy for clinicians to demonstrate quality, achieve recognition, qualify for payor incentives, avoid CMS penalties and earn ABIM MOC points.
AGA-FDA Regulation and Reimbursement Workshop: New Dates Have Been Set
Oct. 17, 2013Do not miss the opportunity to support and stimulate investment and innovation in the development and delivery of new technologies in gastroenterology.
AGA Tech Summit: Advancing GI Through Innovation
Oct. 17, 2013Don’t miss your opportunity to support and stimulate investment and innovation in the development and delivery of new technologies in gastroenterology.
CMS Proposes PQRS Changes — Are You Prepared?
Oct. 4, 2013CMS has proposed a number of updates to the Physician Quality Reporting System (PQRS), one of which is the proposal of a new individual measure for screening colonoscopy adenoma detection rate.
Approaching the Self-Insured Employer
Oct. 4, 2013The cost of colonoscopy continues to come under scrutiny in the media, leading to increased pressure on physicians to better define quality and control. Peter S. Margolis, MD, discusses why a bundle, or “one-pay price”, for a colon cancer screening service line is attractive to self-insured employers who are concerned about the bottom line.
The Bureaucracy of Regulation: Is it profitable for you to comply?
Oct. 4, 2013
The transition to ICD-10 on Oct. 1, 2014, will require new coding systems, new software and a whole new understanding. In addition to ICD-10 obstacles, GI practices will be presented with significant changes to PQRS.
Are you prepared to face these challenges? Lawrence R. Kosinski, MD, MBA, AGAF, chair, AGA Insitute Practice Management & Economics Committee, discusses the importance of maintaining compliance.
Introducing the AGA ICD-10 Resource Center
Oct. 4, 2013There are only 361 days left to transition from the use of ICD-9 code sets to ICD-10 codes sets. AGA has created an ICD-10 Transition Resource Center to ensure members don't lose out on revenue during this transition period.
VBPM Proposed Changes Will Impact Groups of 10 or More
Oct. 4, 2013CMS proposes new changes to the value-based payment modifier (VBPM) that may impact your practice.
CMS Changes E/M Documentation Guidelines
Oct. 3, 2013CMS announced major changes to evaluation and management (E/M) documentation guidelines. This is a significant departure from past E/M reporting guidelines and will make documenting visits easier for all GIs.
Practice Management Component Reintroduced to the 2014 AGA Clinical Congress Program
Oct. 3, 2013The 2014 AGA Clinical Congress will provide information on tools that can help clinicians thrive in the new world of value-based health care.
AGA Comments on Medicare Proposed Payment Rules
Sept. 26, 2013AGA, along with ACG and ASGE, provided comment on Medicare's proposed 2014 payment rules. Of particular concern to GI was a proposal to cap payments for some 200 services at the outpatient prospective payment system or ambulatory surgical center rate.
Join the Discussion on Enhancing Cooperation in Medical Device Development
Sept. 19, 2013Join key stakeholders in the development and delivery of new medical technologies to address communication gaps regarding their roles and expectations attributed to device innovation and commercialization.
Improve the Efficiency and Performance of Your Practice
Sept. 12, 2013McVey Associates, in partnership with the AGA Institute, offers a series of seminars and audio conferences that effectively address the most pertinent reimbursement, coding and compliance issues.
Building Your Nonprocedural Business Lines
Sept. 6, 2013AGA experts provide insights and advice on how to build nonprocedural business lines in nutrition, geriatrics and women's health.
Bundled Payments: What You Need to Know and Why
Sept. 6, 2013With health-care expenditures consuming larger and larger percentages of the federal budget, policymakers are exploring alternatives to fee-for-service payment. AGA is currently working to provide a framework to serve as an example of a bundled payment model that could be applicable to gastroenterology.
What GIs Need to Know About Value-Based Reimbursement
Sept. 6, 2013
Medicare plans to accelerate programs linking physician reimbursement to quality. By 2017, physicians will begin receiving bonuses or penalties, known as the physician value-based modifier, based on performance.
The chair of the AGA Institute Clinical Practice and Quality Management Committee outlines how this system will impact gastroenterologists and what you can do to stay ahead of the changes and thrive in this new accountable-care environment.
AGA Releases List of Excellent IBD Doctors
Sept. 5, 2013AGA has announced the first group of clinicians to receive recognition in the Health Care Incentives Improvement Institute's Bridges to Excellence IBD Care Recognition program. Learn how you can get recognized.
Learn How Value-Based Care is Influencing Medical Device Innovation
Sept. 5, 2013Join key stakeholders in the development and delivery of new medical technologies to address communication gaps regarding their roles and expectations attributed to device innovation and commercialization.
Tomorrow — ASC Quality Data Submission Deadline
Aug. 22, 2013By tomorrow, Friday, Aug. 23, ASCs that provide services to Medicare beneficiaries must report to CMS 2012 volume data for certain procedures and verify their use of a safe surgery checklist during 2012 or face payment reductions from Medicare in 2015.
GIs In and Out of Congress Advocate for Fair Payment
Aug. 22, 2013Joel V. Brill, MD, AGAF, participated in the Alliance of Specialty Medicine's annual legislative conference during which payment reform was an active topic of conversation. Read what Dr. Brill discussed with and heard from members of Congress and their staff on the AGA Washington Insider, a policy blog for GIs.
GIs: “Be at the Table Or…Be On the Menu”
Aug. 8, 2013
Fernando Carreira, MD, from South Denver Gastroenterology, CO, and a member of the AGA Public Policy & Advocacy Committee, participated in the Alliance of Specialty Medicine’s annual legislative conference. Dr. Carreira was thankful that he made the time to attend to advocate for his fellow GIs as well as the profession as a whole.
After spending two days listening to and meeting with U.S. Representatives, Senators and legislative aids, Dr. Carreira became even more aware of the need for physicians to be involved in the legislative process. More and more decisions are being made in Washington that impact the practice of GI and patient care. According to Dr. Carreira, “As they say, physicians must be at the table or we’ll be on the menu.”
SGR Reform Legislation Clears Energy and Commerce Committee
Aug. 1, 2013This week, the House Energy and Commerce Committee unanimously approved bipartisan legislation, H.R. 2810, the Medicare Patient Access and Quality Improvement Act that reforms the current Medicare physician payment system by repealing the sustainable growth rate (SGR) formula and replacing it with a system that links physician payments to quality measures.
House Panel Approves SGR Reform Legislation
July 25, 2013The House Energy and Commerce Health Subcommittee unanimously approved legislation that reforms the current Medicare physician payment system by repealing the sustainable growth rate formula (SGR) and replacing it with a system that links physician payments to quality measures. The AGA appreciates the committee’s willingness to accommodate our concerns and their commitment to repealing the current broken physician payment formula by replacing it with a system that transitions physicians to a more value-based one driven by quality measures that are meaningful and applicable to each specialty.
AGA Fights for GI on Capitol Hill
July 11, 2013During the Alliance of Specialty Medicine annual legislative fly-in, AGA members met with congressional members and government representatives to discuss issues of importance to GI, including Medicare physician payment reform, medical liability reform and physician workforce shortages.
New Aetna Fee Schedule to Affect National Pathology Labs
June 27, 2013Aetna recently announced a new fee schedule for clinical laboratory and anatomic pathology services that would cut payments to nationally contracted laboratories effective Monday, July 1. While these payment reductions do not currently affect GI practices, AGA is closely monitoring the issue and will continue to update you as new fee schedules are announced.
GI Outlook 2013 Addresses Critical Changes in GI Practice Management
June 20, 2013Get timely information on the upcoming changes in health care and learn how they will impact your GI practice at GI Outlook 2013.
AGA to Help Ease Regulatory Burden on GI Community
June 13, 2013AGA has created a regulatory workgroup to identify key issues of concern to the GI community. Watch Michael L. Kochman, MD, AGAF, chair of the regulatory workgroup, outline AGA’s regulatory priorities for the coming year in this video.
Improving Payment Modifier: AGA Participates in the “Super-User” Network
June 7, 2013The Patient Protection and Affordable Care Act directed HHS to develop and implement a budget-neutral payment modifier that will adjust Medicare physician payments based on the relative quality and costs of care provided. AGA, in collaboration with the Alliance of Specialty Medicine, is participating in a “super-users” network for CMS regarding the new value-based payment modifier to share concerns and provide recommendations on the program.
Hearings Continue on Medicare Payment Reform
May 16, 2013
In a symbolic act, the House of Representatives is scheduled to vote on H.R. 45, legislation that would repeal the Patient Protection and Affordable Care Act. The repeal is expected to pass the House, but is not expected to be taken up by the Senate, which is controlled by the Democrats.
One repeal that both Republicans and Democrats can agree on is the need to repeal the sustainable growth rate formula used to calculate physician payment updates under Medicare. Committees in both chambers of Congress have been conducting hearings to examine transitioning physicians to a more value-based system that rewards physicians for quality outcomes and efficiency of care.
Follow AGA’s Roadmap to the Future of GI — How to Thrive in the New World of Accountable Care
May 16, 2013As reimbursement shifts from fee-for-service to value-based reimbursement, it is essential for physicians to focus on the quality of services provided. AGA’s Roadmap to the Future of GI will help you make the most of health-care reform and implement changes in your practice so you can not only survive, but thrive in the new accountable-care environment.
AGA Helps You Manage Your HCV Patient Population
May 2, 2013Are you treating more and more hepatitis C patients? To assist your practice in improving care of this growing population, the AGA has created an HCV clinical service line.
Improve Patient Care and Enhance Practice Efficiency and Profitability
April 25, 2013Learn how the AGA Digestive Health Outcomes Registry® can help your practice meet payor requirements, report to CMS Physician Quality Reporting System, enhance quality and more.
Medicare Experiments with Bundled Payments Under New Health-Care Act
April 18, 2013The Bundled Payments for Care Improvement Initiative (BCPI), which is being spearheaded by the Center for Medicare & Medicaid Innovation, gives Medicare officials the authority to experiment with new payment models, including moving away from paying separately for each service provided, and instead paying for episodes of care.
AGA Introduces a New Process for Clinical Practice Guideline Development
April 5, 2013AGA recently introduced a new process for clinical practice guideline development, utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. As part of the new process, AGA is asking members to submit topic suggestions.
Providing Behavioral Therapy for Obesity? Understand the Medicare Benefit
April 2, 2013Effective with dates of service on or after Nov. 29, 2011, Medicare covers intensive behavioral therapy for obesity for the prevention or early detection of illness or disability. Learn about the services the Medicare benefit covers, what a therapy visit should include, billing codes and more.
GI Outlook 2013: The Practice Management Conference
March 28, 2013Get practical advice and how-to information on enhancing your practice's efficiency, performance and service quality.
CMS issues guidance on coding for fecal incontinence procedure
March 28, 2013CMS has developed a new code for the Solestra procedure, which will affect how hospitals and ambulatory surgery centers bill Medicare for payment.
CMS Issues Guidance on Coding for Fecal Incontinence Procedure
March 28, 2013CMS has developed a new code for the Solestra procedure, which will affect how hospitals and ambulatory surgery centers bill Medicare for payment.
Take Action on the Colonoscopy Co-Insurance Medicare Issue
March 14, 2013Medicare patients who have a screening colonoscopy continue to be subjected to a co-insurance when the screening turns therapeutic. AGA advocates that legislators correct this issue, but we need your help to reach out to Congress to make sure the voice of GI is heard.
What GI Physicians Need to Know About QRURs and the Value-based Payment Modifier
March 8, 2013Quality Resource and Use Reports (QRURs) provide physicians with information about how the value modifier will affect their payment. The QRURs provide comparative quality and cost data for quality improvement purposes; the first time that many physicians will have seen such performance information from CMS.
The AGA Solution — Avoid CMS Penalties and Achieve Recognition
March 8, 2013Up until this point, participation in PQRS has only provided a potential benefit; however, failure to participate in PQRS will result in a financial penalty in 2015. Fortunately, AGA is here to help you meet PQRS requirements and avoid penalties.
Still Time to Register for the 2013 AGA Tech Summit
March 7, 2013This is your opportunity to explore critical elements impacting the likelihood of success in developing and obtaining adoption and coverage for new GI medical technologies. You will hear directly from the FDA, private payors and medical device executives who will discuss specific requirements generally needed.
Sequester to Begin Tomorrow — Implications for GI
Feb. 28, 2013It doesn't appear that Congress and the president will come to a deal to stop the automatic spending cuts that go into effect tomorrow. Learn what's in store for the GI community in the near term and note that a key date in the negotiations is March 27, when the continuing resolution keeping the government funded expires. AGA representatives meet with members of Congress every day to urge them to take action to address this pending crisis.
AMA/RUC Surveys on ERCP and EUS Procedures Begin Today
Feb. 27, 2013If you are selected to participate in these surveys, please do not forfeit this important opportunity to provide direct input into the valuation of GI services. While it will take time to complete each survey, your participation is crucial to ensuring that GI procedures are valued accurately and fairly.
Privately Insured Patients Not Financially Responsible for Screening Colonoscopy
Feb. 21, 2013In a major win for the GI community, the government has clarified its policy related to cost sharing for colonoscopy for privately insured patients. Specifically, an FAQ on the implementation of preventive screening benefits in the Patient Protection and Affordable Care Act states that if a screening colonoscopy is performed and a polyp is found and removed during the screening, then an insurer cannot impose cost sharing since it is “an integral part of a colonoscopy.”
A Day on Capitol Hill: AGA President Advocates for GI
Feb. 21, 2013
Last week, right before attending the AGA Governing Board meeting in Washington, D.C., AGA President Loren Laine, MD, spent the day on Capitol Hill. He met with seven representatives and senators, as well as the staff members responsible for health affairs of three other legislators. His goal — to discuss subjects of importance to gastroenterology and gastroenterologists with members of Congress and their staffs, hopefully learning from them, but also having them learn from him about some of GIs key issues. His conversations focused on issues including Medicare, NIH funding and colonoscopy cost sharing. Dr. Laine is hopeful that his visit will help strengthen GI’s voice on Capitol Hill.