AGA stumps to alleviate regulatory burden on physicians — 3 things to know

The American Gastroenterological Association is petitioning CMS, payers and Congress to alleviate some of the regulatory burden placed on physicians.

AGA is targeting three specific areas.

1. Prior authorization. The AGA wants payers to standardize prior authorization requirements, while making the standardized requirements transparent and easily accessible.

The group also wants a process that'll allow for "peer-to-peer" dialogues, specifically in the case of prior authorization for prescription drugs or biologic therapies.

2. Step therapy. AGA wants to lessen the burden of step therapy on physicians and the physician practice. The organization supports The Restoring the Patient's Voice Act, which would provide patients an appeal process when subjected to step therapy.

3. Stark reform. The AGA feels Stark self-referral laws prohibit care delivery innovation because they limit physicians from referring patients to an entity they have a financial interest in, which in turn limits advanced alternative payment model participation.

AGA supports the Medicare Card Coordination Improvement Act, which would allow CMS to create Stark law exceptions for APMs and would remove barriers in the development and execution of currently prohibited arrangements.

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