Summer 2017
www.pasg.org
PSG
INSIDE
President’s Message
2017 PSG Annual Meeting
The Train Has Left the Station
Legislative Update
By Ralph D. McKibbin, MD, FACP, FACG, AGAF I recently had discussions with gastroenterologists from several Pennsylvania practices who are still trying to decide how they will handle the reporting for MACRA/MIPS. There can be no delay. The time for indecision has passed. It is not too late to hop aboard. Clinicians who decide not to participate in 2017 are assured a -4% penalty in 2019. The penalty rises to -5% in 2020, -7% in 2021, and -9% in 2022. One year ago, the Centers for Medicare and Medicaid Services (CMS) released the details of how practitioners participating in Medicare will be reimbursed beginning in the year 2019. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) enacted in 2015, repealed the Medicare sustainable growth rate formula (SGR) and created this new reimbursement system. The good news is that in 2017 and 2018 and until December of 2019 there will be a 0.5% annual increase as part of the update for Medicare fee for service providers. The bad news is that beginning in 2017, we must choose how we will be evaluated on performance measures and activities under the merit-based incentive payment system (MIPS) or as part of an advanced alternative payment model (APM). The
adjustments to your payment in 2019 will be based on how you report the data this year. For GI, CMS estimates there are about 12,600 eligible clinicians that would be subject to MIPS. This includes physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists working in gastroenterology practices. 83% of Medicare enrolled gastroenterology clinicians are expected to be MIPS eligible clinicians. In its original estimates, CMS estimated that roughly 62% would be eligible for a bonus but 38% would be subject to payment cuts. This estimate was likely based on earlier Physician Quality Reporting System (PQRS) data. Approximately 15,000 gastroenterologists were eligible to participate in PQRS in 2014. Of those, approximately one-third received a downward PQRS payment adjustment in 2016. The recent relaxation of reporting requirements has created an opportunity to avoid additional payment cuts. These numbers have been revised and an estimated 95.6% of eligible GI participants can avoid a payment cut. You must participate, however, to avoid the cuts. Report as little as one quality measure for one patient to yield three points or one improvement activity and avoid a penalty continued on page 11
Pennsylvania’s Medical Marijuana Law Clinically Integrated Networks Membership Application & Benefits PRESIDENT Ralph D. McKibbin, MD Blair Gastroenterology Associates 810 Valley View Blvd. Altoona, PA 16602-6342 (814) 946-5469 (Phone) ralphmckibbin@hotmail.com PRESIDENT-ELECT Richard E. Moses, DO, JD Phila. Gastroenterology Consultants, Ltd. 700 Cottman Ave., Suite 201 Philadelphia, PA 19111 (215) 742-9900 (Phone) remoses@mosesmedlaw.com SECRETARY Ravi Ghanta, MD Digestive Disease Associates 1011 Reed Ave., Suite 300 Wyomissing, PA 19610 (610) 374-4401 (Phone) rghanta@hotmail.com TREASURER David L. Diehl, MD Geisinger Medical Center Mc21-11, 100 N. Academy Ave. Danville, PA 17822 (570) 271-6439 (Phone) dldiehl@geisinger.edu ADMINISTRATIVE OFFICE ASSOCIATION EXECUTIVE Robbi-Ann M. Cook 777 East Park Drive, P.O. Box 8820 Harrisburg, PA 17105-8820 (717) 558-7750 ext. 1584 gastro@pamedsoc.org
Rumblings Editor Manish Thapar, MD gastro@pamedsoc.org