CMS released its proposed rule for policy changes to the 2011 physician fee schedule effective Jan. 1, 2011, and its implementation of key provisions under recently enacted health-reform legislation, the Affordable Care Act.
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July 01, 2010
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![]() Eugene Chang, MD, AGAF Basic Research Councillor F. Taylor Wootton III, MD, AGAF Private Practice Councillor |
CMS Releases 2011 Physician Fee Schedule Proposed RuleCMS released its proposed rule for policy changes to the 2011 physician fee schedule effective Jan. 1, 2011, and its implementation of key provisions under recently enacted health-reform legislation, the Affordable Care Act.
Lead Story, continued
The proposed rule will be published in the Federal Register on July 13. CMS will accept public comments on the rule until Aug. 24. AGA will also submit comments for CMS' consideration prior to release of the final rule by Nov. 1, 2010. Read more about the components of the proposed rule as well as a detailed summary. Stay tuned to AGA eDigest and the AGA Washington Insider for a more comprehensive analysis of this proposed rule. Download the fact sheets released by CMS: CGH Image of the MonthTension Hemothorax: A Dreaded Complication of Percutaneous Liver Biopsy A 52-year-old man was admitted to a hospital for percutaneous liver biopsy. The indication was to assess his fibrosis stage to determine his treatment for genotype 1b chronic hepatitis C. Prebiopsy preparation was performed in accordance with recent guidelines. The optimal position for needle puncture was marked with ultrasound guidance. The patient was taught to hold his breath in full expiration immediately before biopsy. The patient developed hypovolemic shock two hours after the procedure. He did not complain of any abdominal pain or shortness of breath. Immediate assessment with bedside abdominal ultrasound did not reveal any free intra-abdominal fluid. An urgent CT scan showed a massive right hemothorax with tension effect. The liver biopsy result was a stage two liver fibrosis compatible with chronic hepatitis C. A small piece of normal lung tissue was also included in the liver biopsy specimen (figure). RESEARCHGrants Available for Fellows, Junior Faculty & Experienced InvestigatorsInvestigators at all stages of their careers are invited to apply for research funding from the AGA Foundation for Digestive Health and Nutrition (FDHN). For fellows: Applicants must be MDs or MD/PhDs currently in a gastroenterology-related fellowship, clinically active at a North American institution and committed to an academic career. They will have completed at least two years of research training at the start of this award. For junior faculty: The award is intended to support young faculty (not fellows) who have demonstrated promise and have a record of accomplishment in research. Candidates should be in the beginning years of their careers; no more than five years shall have elapsed following the completion of the applicant's clinical or postdoctoral training and the start date of this award. For established investigators: Applicants must hold faculty positions at accredited North American institutions, must be AGA members at the time of application and must have established themselves as independent investigators in the field of gastric biology. Applications for all awards are due Sept. 3. Complete eligibility requirements and application information are available on FDHN's Web site. Doctors Identify Predictors of Response in Pediatric Ulcerative ColitisDoctors performed a prospective study of children with severe ulcerative colitis, assessing outcomes and identifying predictors of nonresponse to intravenous corticosteroids. According to their study results, which were published in Gastroenterology, the pediatric ulcerative colitis activity index, calculated on days three and five of steroid therapy, can identify patients requiring salvage therapy. Infliximab is an effective therapy in steroid-refractory pediatric ulcerative colitis. What Determines Gastroesophageal Varices in Chronic Hep C?In a study appearing in Gastroenterology, doctors identified the incidence and predictors of de novo gastroesophageal variceal formation and progression in a large cohort of patients with chronic hepatitis C and advanced fibrosis. They found that development of varices in patients with chronic hepatitis C is associated with patient race/ethnicity and laboratory markers of disease severity. Prolonged low-dose peginterferon-α2a therapy and ß-blockers do not reduce the risk of variceal development or progression. Early Use of TIPS Improves Mortality in CirrhosisPatients with cirrhosis in Child-Pugh class C or those in class B who have persistent bleeding at endoscopy are at high risk for treatment failure and a poor prognosis, even if they have undergone rescue treatment with a transjugular intrahepatic portosystemic shunt (TIPS). According to data published in the New England Journal of Medicine, in patients with cirrhosis who were hospitalized for acute variceal bleeding and at high risk for treatment failure, the early use of TIPS was associated with significant reductions in treatment failure and in mortality. Early Laparoscopic Cholecystectomy Improves Outcomes After Endoscopic SphincterotomyPatients with choledochocystolithiasis generally undergo endoscopic sphincterotomy followed by laparoscopic cholecystectomy. However, many patients receive this surgery six to eight weeks after endoscopic sphincterotomy. There is a high conversion rate of elective laparoscopic cholecystectomy after endoscopic sphincterotomy, and patients can develop recurrent biliary events during the waiting period. In a randomized trial to evaluate timing of laparoscopic cholecystectomy after endoscopic sphincterotomy, recurrent biliary events occurred in 36 percent of patients whose laparoscopic cholecystectomy was delayed for six to eight weeks; study results were published in Gastroenterology. Early laparoscopic cholecystectomy appears to be safe and might prevent the majority of biliary events in this period following sphincterotomy. POLICYMedicare Physician Payment Cuts OverturnedAfter months of fighting against Medicare physician payment cuts, AGA is glad to announce that the president has signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act into law. It provides a 2.2 percent update in payment rates, retroactive from June 1 through Nov. 30, 2010. CMS has instructed its carriers to process claims at the 2.2 percent rate and will reprocess any claims at the negative 21.3 percent rate as soon as possible to reflect the new rate. CMS has indicated that providers do not need to resubmit claims that were already submitted to their contractors. AGA will continue to provide any new information on this issue from CMS. AGA Policy BlogLearn more about these cuts and other happenings in DC through the AGA's policy blog. OIG Issues Statement on Waiving Beneficiary Cost-Sharing AmountsThe Office of Inspector General (OIG) has released a policy statement to assure providers, practitioners and suppliers affected by retroactive increases in payment rates resulting from the operation of new federal statutes or regulations that they will not be subject to OIG administrative sanctions if they waive retroactive beneficiary liability provisions. Read the full statement. Occasionally, the operation of new federal statutes or regulations will result in payment rate increases that apply retroactively during the period from the effective date of those payment rate increases until the date on which CMS (or the relevant Medicare administrative contractor, fiscal intermediary or carrier) implements the new, increased payment rates (the "retroactive period"). CLINICAL PRACTICEHow Does Prior Authorization Impact Your Practice?The AGA invites you to participate in a 10-minute survey on your experience with health insurer prior authorization and prior notification programs. This survey is open to physicians and their practice staff and will help the AMA determine how they can best equip your practice to effectively address prior authorization and prior notification program issues. Opportunity for Nonparticipating Physicians/Practitioners to Become ParticipatingIn consideration of the recent enactment of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, which established a 2.2 percent update to the Medicare physician fee schedule (MPFS), CMS is offering physicians and other practitioners (whose current participation status is non-participating) the opportunity to become participating. This opportunity is available through July 16, 2010. Non-participating physicians/practitioners who would like to become a participating physician/practitioner should download and complete the Medicare participating physician or supplier agreement form (CMS-460). Any new CMS-460 form received during this limited enrollment period will be retroactive for claims with dates of service of Jan. 1, 2010, and later. However, the change in participation status will only apply to new MPFS claims submitted after your new status as a participating physician/practitioner is processed. Claims previously submitted and processed will not be adjusted for only a change in participation status. Medicare claims administration contractors will accept and process requests to become a participating physician/practitioner that are submitted on the CMS-460 form and are postmarked on or before July 16, 2010. It Is Not Too Late to Participate in PQRIJoin the growing number of eligible professionals who are participating and receiving a Physician Quality Reporting Initiative (PQRI) bonus of up to 2 percent of their total Medicare Part B allowed charges for the applicable reporting period. There are multiple reporting methods available for providers who wish to report through claims or registries for the July 1, 2010, through December 31, 2010, PQRI reporting period. We would suggest going to page 17 of the 2010 PQRI implementation guide. You can earn the full 12-month payment by submitting your quality data to CMS through the use of the registry or electronic health record (EHR) reporting option. Check out the qualified registries or EHR software for 2010 PQRI reporting. If you have questions, contact the QualityNet help desk at 866-288-8912 from 7 a.m. to 7 p.m. CT or via e-mail at qnetsupport@sdps.org. AGA Registry Qualifies for PQRI ReportingThe AGA Digestive Health Outcomes Registry™ has qualified to submit data to CMS on behalf of its eligible professionals for the 2010 PQRI reporting of the hepatitis C measures group (available Fall 2010). This is just one of many practice benefits of the registry. Learn more about how the AGA Registry can help your practice. You Can Still Participate in 2010 eRx Incentive ProgramIt's not too late to start participating in the 2010 electronic prescribing (eRx) incentive program and potentially qualify to receive a full-year incentive payment. To successfully meet reporting criteria and be considered incentive eligible, individual eligible professionals must report the eRx measure at least 25 times (for eligible patient encounters) and the Medicare Part B physician-fee-schedule allowed charges for services in the eRx measure's denominator should comprise 10 percent or more of the eligible professional's total 2010 estimated allowed charges. For the 2010 reporting period, eligible professionals who successfully report the eRx measure will be eligible to receive an eRx incentive equal to 2 percent of their total Medicare Part B physician-fee-schedule allowed charges for services performed. Eligible professionals must have adopted a “qualified” eRx system as defined in the eRx measure specifications. Check if your system meets those requirements (go to the downloads section and select the entry marked “2010 eRx Measure Specification and Release Notes.”) Eligible professionals do not need to sign up or pre-register to participate in the 2010 eRx effort. Reporting the quality data code (G8553) for the eRx measure to CMS through claims or submission of data via a qualified registry or from a qualified electronic health record is all that is necessary to participate in the program. Eligible professionals should review the educational products CMS has created on how to get started with eRx reporting. Additional resources
Questions? Contact the QualityNet Help Desk at 866-288-8912 from 7 a.m. to 7 p.m. CT or via e-mail at qnetsupport@sdps.org. UpToDate® Free Topic of the MonthProduced in cooperation with the AGA Institute, UpToDate® is a subscription-based clinical information resource available on the Web, CD-ROM and pocket PC handheld devices. Each month, a free topic is made available on the AGA Web site. This month's free topic is: Nearly 232 physicians write more than 673 topic reviews for UpToDate in gastroenterology and hepatology alone. UpToDate provides gastroenterologists with access to more than 60,000 pages of original, peer-reviewed text, 160,000 MEDLINE abstracts, drug information and drug interactions databases, and hundreds of patient information handouts across 12 specialties. Moreover, UpToDate is used by tens of thousands of clinicians in more than 110 countries and by hundreds of premier medical institutions worldwide. Order your subscription to UpToDate. EDUCATION & TRAININGHelp Us Plan DDW® 2011 ProgrammingThank you for helping to make the 41st annual Digestive Disease Week® (DDW) 2010 a success! We are now beginning the process of planning for DDW 2011 in Chicago, IL from Saturday, May 7 to Tuesday, May 10, 2011, and your help is wanted. The AGA Institute Council has 12 sections whose leaders guide the programming for DDW invited speaker lectures and abstract-based sessions. The council section leaders want your feedback to make DDW 2011 the best yet. All members are encouraged to get involved with their sections:
The council sections have provided an overview of their highlights from DDW 2010. You can view these highlights by visiting the links below:
Valuable Resources Available from the 2010 AGA Spring Postgraduate CourseThe AGA Institute's 2010 Spring Postgraduate course, Managing Digestive Diseases in the Next Decade: Controversies and New Developments, presented attendees with a look at what is on the horizon for the diagnosis and treatment of digestive diseases and how these latest advances can be incorporated into practice. If you could not attend the course or did attend and want to enhance your learning experience, take advantage of these valuable course resources, including a CD-ROM, online sessions and a course syllabus. The CD-ROM and online sessions contain the complete audio track of all general and clinical challenge sessions as well as corresponding slides. The CD-ROM also includes the luncheon breakout sessions. The online sessions and the CD-ROM are fully searchable by topic or author, and the online sessions offer CME credit. Buyers can save with a special offer that gives them access to the online sessions for just $10 — $25 in savings — with purchase of the CD-ROM. The course syllabus contains comprehensive details of all sessions, including abstracts, key points, references, slides, graphs, charts and tables. Learning objectives and complete reference lists are also included. While supplies last, the CD-ROM for the 2009 Spring Postgraduate course, Applying New Evidence to Clinical Practice, is available at a discounted price. Valuable Resources Available from the 2010 AGA Clinical CongressManaging GI Conditions: Integrating Scientific Evidence with Clinical Experience Have easy access to the most up-to-date clinical information in the field. Syllabus ANNOUNCEMENTSAGA Represents at AMA House of Delegates Specialty Showcase
Ikuo Hirano, MD, program director at Northwestern University, and one of his second-year fellows, John Paul Norvell, MD, staffed the exhibit table with AGA materials. They spoke with a number of students on the range of practice and research opportunities in gastroenterology, and the role of the AGA as their society home. The AGA was the only GI society represented at the showcase. Apply for AGA FellowshipApplication Deadline: July 19, 2010 The AGA is now accepting applications for fellowship. Fellowship honors superior achievement in clinical private or academic practice and in basic or clinical research. AGA members must meet specific criteria in order to apply. PUBLICATIONSGastro & CGH Video Abstracts of the MonthWatch Douglas Corley, MD, discuss his recently published Gastroenterology article, “Proton Pump Inhibitors and Histamine-2 Receptor Antagonists Are Associated with Hip Fractures Among At-Risk Patients.” Provide your thoughts and comments on this important study via the YouTube comments tool. Watch Dario Sorrentino, MD, discuss his recently published Clinical Gastroenterology and Hepatology article, “Low-Dose Maintenance Therapy With Infliximab Prevents Postsurgical Recurrence of Crohn's Disease.” Provide your thoughts and comments on this important study via the YouTube comments tool. Call for Papers on Clinical Trials: GastroenterologyGastroenterology is committed to advancing clinical practice in the field of digestive disease. Recognizing that clinical trials generally have the greatest impact of all studies on clinical practice, Editor Anil K. Rustgi, MD, and his associate editors strongly encourage authors to submit their manuscripts on clinical trials (diagnostic validation, therapeutic efficacy) of drugs, biological materials and devices in digestive, liver and pancreatic diseases, including studies at phases I, II and especially III, to Gastroenterology for consideration. The journal is also interested in publishing trials in endoscopic and imaging modalities. There are several important reasons to submit clinical trial research for publication in Gastroenterology:
To submit your manuscript to Gastroenterology, go to www.editorialmanager.com/gastro. For important information on how to report clinical trials, go to www.gastrojournal.org/authorinfo. To review the current and past issues of the journal, go to www.gastrojournal.org. CLASSIFIEDSPlace GI position listings and activity announcements in AGA eDigest.For only $82.50, you can place an ad of 100 words or less in two consecutive issues and for $165 in four consecutive issues. Ads can also be placed in AGA Perspectives, AGA's bi-monthly magazine. If you place ads in both AGA Perspectives and AGA eDigest, you will receive a 10 percent discount. For more information, contact Alissa Cruz at acruz@gastro.org or 301-272-1603. Connecticut
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