On July 3, the Centers for Medicare and Medicaid Services announced plans to review and revise physician reimbursement rate setting under the Medicare Part B program. The three GI societies have been strong advocates of improved transparency. Here are four insights on the proposed rule and the societies' reaction.
1. Harry E. Sarles Jr., MD, FACG, president of the ACG; John I. Allen, MD, MBA, AGAF, president of the AGA; and Colleen M. Schmitt, MD, MHS, FASGE, president of the ASGE, released a joint statement reacting to the proposed changes and expressing hope for further progress.
2. The proposed changes to the Medicare Physician Fee Schedule aim to establish more transparent payment rates and allow for more public input before rates are set. The American College of Gastroenterology, American Gastroenterological Association and American Society for Gastrointestinal Endoscopy issued a joint statement expressing encouragement for the move towards transparency.
3. In the joint statement, the three societies express concern over colonoscopy reimbursement. The procedure is one of the major codes under CMS review that are scheduled for decision making in 2015. The ACG, AGA and ASGE request that CMS delays revision to these codes, including colonoscopy, or creates another avenue for input on proposed reimbursement changes. The groups argue that publishing changes to colonoscopy reimbursement in the Medicare Physician Fee Schedule Final Rule in November allows fewer than 60 days to prepare for the changes.
4. The GI societies call for three key elements in the Medicare rate-setting process including:
• Stakeholder participation
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