2017 Spring Rumblings newsletter

Spring 2017

www.pasg.org

PSG

President’s Message

INSIDE

A Stitch in Time Saves Nine

2017 Annual Meeting

Medicare CAC Updates

By Ralph D. McKibbin, MD, FACP, FACG, AGAF As President of the Pennsylvania Society of Gastroenterology (PSG), I am often pulled aside by other gastroenterologists who wish to voice their concerns about problems that affect their professional lives. The list of issues covers a broad area but usually involve patient care issues such as insurance coverage, formulary restrictions, contract payments, and state legislative issues. Payment issues and uncertainty brought on by the change in the political arena are also common. Advocacy for patients and payment stability are, appropriately, at the forefront but there is one item that keeps emerging that involves the ability of all gastroenterologists to perform their duties to the best of their abilities now and in the future, that is, Maintenance of Certification (MOC).

We are fortunate in Pennsylvania to have the Pennsylvania Medical Society (PAMED) as a resource and advocate.

They have been at the forefront of the drive for modernization and transparency in the MOC process for all specialists.

The American College of Physicians (ACP) is also active on this issue. The PSG endorsed the no-confidence position statement issued by PAMED in June of

DDNC Report 2016. The national gastrointestinal societies have also been involved in speaking for gastrointestinal specialists. The American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), and the American Society of Gastrointestinal Endoscopy (ASGE) have been vocal on the need for change and have developed alternative education materials for MOC. The American Board of Internal Medicine acknowledges that there are problems. While there has been some progress made on the issue, the underlying faults persist.

The time-consuming, expensive, and highrisk process does not fit into the modern way of practice. We live in a real-time world of rapidly changing information which requires us to be “plugged-in” with online reference databases like Up-to-Date ™, state regulatory databases such as Pennsylvania’s Prescription Drug Monitoring Program (PDMP), online formularies, etc. Additionally, we are asked to practice in an evidence-based fashion utilizing societal guidelines and peer-reviewed data as our guide. The MOC pathway does not conform to these same standards.

The undercurrent of dissatisfaction toward the cumbersome MOC process was made very apparent when I had the recent opportunity to participate in a meeting with leadership from many of the state continued on page 11

Legislative Update PAMED Specialty Leadership Cabinet Report New Members 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

2 Medicare CAC updates F. Wilson Jackson, MD The quarterly Contractor Advisory Committee (CAC) meeting was held February 15, 2017 at the Novitas Camp Hill office. The CAC is a forum for the medical community to comment on Medicare policy as it is applied within a jurisdiction. The administrative function of Medicare is broken down into 12 jurisdictions and each jurisdiction administers local policy and oversees fraud and abuse functions. We are in Jurisdiction L (JL in Medicare parlance) along with NJ, DE, MD, and metro Washington DC. Local Coverage Determinations (LCD) is the vehicle by which policy is applied within any particular jurisdiction. Some LCDs are merely updates to existing policies while others are for new procedures or medications that come available.

LCDs are also occasionally revised when there is a sudden increase in a particular procedure code where abuse may be suspect. Your PSG organization has a representative for the committee.

At the most recent meeting, the LCDs presented and discussed did not have direct relevance to gastroenterology. These included magnetic stimulation to treat depression, ophthalmic imaging, wound care, and treatment of varicose veins.

Also presented were error rate reduction efforts, MACRA implementation, and others areas of policy and legislation.

Below is a summary.

Novitas JL Communications You or someone in your practice can receive twice a week communications from Novitas. Some of the information may not be directly relevant to your day-to-day practice, but you also can get some measure of all the activity within the bureau. To sign-up, go to http://www.novitas-solutions.com/ webcenter/portal/MedicareJL/pagebyid?contentId=00007968

CERT Error Rate The CERT, Comprehensive Error Rate Testing, program is the part of Medicare that overseas billing errors, inadequate documentation, and inappropriate billing for claims sent to Medicare. They have established benchmarks that they strive to achieve. They use comparative data from different states within a jurisdiction but also measure against national benchmarks. The national error rate is 10.0% for Part A claims and 11.7% for Part B. Broadly defined, an “error� is any claim where a payment adjustment is applied. Oftentimes, these are oversights or incomplete records in the medical record. The composite JL region (our region) error rate is 7.6% for Part A and 12.3% for Part B. The Pennsylvania error rate is 6.5% for Part A and 14.1% for Part B. Washington DC leads our jurisdiction with a Part A error rate of 27.5% (I’ve refrained from any editorial comment).

After analysis of the greatest areas of mis-submitted Part A claims, Novitas will focus on inpatient rehab units and hospitals which have a projected cumulative improper payment of $575 million over the 12-month study period. Improper dialysis has a projected error adjustment of nearly $100 million and will also be a focus of audit. When examined, the bulk of these errors are missing documentation of prognosis on the plan of care, missing progress notes, missing or delayed certifications, and missing physician signatures. Complete and proper documentation is the key to supporting these services.

In the Part B arena, the source of errors is primarily around office visit codes 99214 and 99213 which will remain a focus of audits. Internal Medicine, Cardiology, Family Medicine, Oncology, and Psychiatry comprise the largest specialties with some of the higher error rate. Ambulance services remain an area with high error rates and an area of ongoing monitoring. Those of you who oversee an in-office lab should be aware that labs have nearly a 20% error rate. The primary driver for lab errors is inadequate documentation of medical necessity for any given lab test.

Ongoing emphasis and the recurrent theme is on improving documentation to support the level or type of service billed. Documentation of non-physician practitioner and physician shared visits are a further area of monitoring.

As always, please let your PSG organization know of questions, concerns or unmet needs.

3 More about MACRA You may be experiencing MACRA saturation but CMS has several resources available to you or your staff.

These include:

FAQ https://www.cms.gov/Medicare/Quality-InitiativesPatient-Assessment-Instruments/Value-Based-Programs/ MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html

Medicare Premiums for 2017 Medicare deductibles, coinsurance, and premium rates for 2017 are: • 2017 Part A-Hospital Insurance: o Deductible: $1,316.00 o Coinsurance:

 $329.00/day for 61st-90th day

 $658.00/day for 91st-150th day (lifetime

reserve days)

 $164.50 a day for 21st-100th day (Skilled

Nursing Facility coinsurance) • 2017 Part B – Medical Insurance: o Deductible: $183.00 a year o Coinsurance: 20 percent If you would like more information, see: https://www.cms. gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/MM9902.pdf

Speech and Swallow Caps There are new limits on total annual coverage for outpatient speech and swallow therapy. I am unaware if a Medicare beneficiary or designate can independently determine when they are near these limits but presumably the therapist working with the patient can counsel the patient when a cap is reached or imminent and coverage no longer available. These rules went into effect January 3, 2017. They are as follows: Outpatient therapy limits for: Physical Therapy (PT) and Speech-Language Pathology (SLP) combined is $1980 Occupational Therapy (OT) is $1980 If you would like more information, see https://www.cms. gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/MM9865.pdf

Webinars past and present https://www.cms.gov/Medicare/Quality-InitiativesPatient-Assessment-Instruments/Value-Based-Programs/ MACRA-MIPS-and-APMs/Quality-Payment-ProgramEvents.html

Fact sheet https://www.cms.gov/Newsroom/MediaReleaseDatabase/ Fact-sheets/2016-Fact-sheets-items/2016-10-25.html

I would stay tuned to these communications as they may change with the new secretary of Health and Human Services, Representative Thomas Price.

Discarded Drugs Those of you who are involved in managing an ambulatory surgical center or infusion program for biologics, should be aware of new regulations in effect surrounding documentation of unused drugs. You will want to use a JW modifier to identify unused drugs or biologics that are then appropriately discarded. This documentation is required as part of the patient record. You can learn more at https://www. cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ MLNMattersArticles/Downloads/MM9603.pdf

4

JOIN PSG AT NEMACOLIN WOODLANDS RESORT for the

2017

Annual Scientific Meeting By: Vinay Chandrasekhara, MD 2017 PSG Program Chair The PSG is planning an educational, family-friendly Annual Scientific Meeting at the Nemacolin Woodlands Resort from September 8-10. We have been fortunate to attract many expert speakers throughout the state of Pennsylvania who will deliver dynamic lectures on a variety of topics related to the field of gastroenterology. Every year, this meeting attracts a large number of GI providers and allows for a social atmosphere to connect with colleagues. I personally enjoy this meeting because it provides me with relevant updates that impact my practice and allows me to keep current with issues in Pennsylvania.

The program will start on Friday, September 8 with cocktails and hors d’oeuvres. The Saturday session begins at 7:45 am and concludes at 12:30 pm. The Sunday session begins at 7:45 am and concludes at noon. Breakfast is provided both mornings prior to the start of the meeting.

In keeping with the meetings, we will have a GI Fellow Jeopardy tournament from 12:30 – 1:30 pm on Saturday with lunch provided. Attendees are encouraged to stay for the tournament to see how many questions they can answer correctly!

In addition to these sessions, we will also hold our annual FIT poster competition, which allows you to review cutting edge research and interact with our energetic trainees within the state. The scientific sessions are designed so participants may have time to spend exploring the resort with families and other guests.

2017 Program Topics Include • GERD – Pitfalls and Pearls • Update on hereditary polyposis syndromes • NASH • Hepatitis C • Organ allocation in Pennsylvania • Advances in the management of refractory IBD • Total pancreatectomy with auto islet cell transplantation • Endoscopic closure of leaks and perforations • EUS-guided pancreaticobiliary interventions • And More!

As you can see, this meeting promises to be an educational, fun-filled weekend. We look forward to seeing at this year’s Annual Scientific Meeting in September at the Nemacolin Woodlands Resort!

Join PAMED’s First-Ever Women Physicians Caucus The Pennsylvania Medical Society (PAMED) invites all women physicians and medical students who are PAMED members to join our new Women Physicians Caucus (WPC).

P Learn about effective networking PVoice concerns and share common

71%

experiences

of female physicians are the ‘breadwinners’ in their family

P Educate and encourage paths to

leadership roles in organized and academic medicine

PEstablish a network of women physician leaders

46%

34%

of the physician workforce in Pennsylvania is made up of women

of current medical students are women

PAdvocate to advance PAMED

policy on issues affecting women and advise the PAMED Board Source: American Medical Women’s Association

Learn more and join the WPC at www.pamedsoc.org/WPC.

Not yet a PAMED member? Join PAMED and your county medical society at www.pamedsoc.org/join or by calling PAMED’s Knowledge Center at 855-PAMED4U (855-726-3348).

17/552Flyer

855-PAMED4U (855-726-3348) • KnowledgeCenter@pamedsoc.org • www.pamedsoc.org

6 The Benefits of Your PSG Membership Annual Meeting • Free to members. The non-member meeting physician registration fee is $175 and $100 for physicians’ assistants and nurses. (Pending members who have a completed application on file are entitled to free registration.)

• The 2017 Annual Meeting will be held September 8-10 at Nemacolin Woodlands Resort in Farmington, PA. • The PSG Annual Scientific Meeting provides an excellent opportunity to earn CME credits.

Interaction with Other State and National Medical Societies • PSG is a member of the DDNC and is represented at their meetings.

• PSG maintains a regular dialogue with the AGA, ACG, and ASGE on national issues that impact Pennsylvania gastroenterologists.

• PSG has a seat on the PA Medical Society (PAMED) Specialty Leadership Cabinet and a vote at their House of Delegates. Together, PSG and PAMED advocate for gastrointestinal issues on a state level.

• The two PA regional governors for ACG are now members of the PSG Board and we will closely collaborate with them on matters of common interest.

Representation by GI Fellows In Training

• Four FITs sit on the PSG Board.

• PSG hosts a FIT poster competition at the annual meeting. Those who submit a poster and attend the meeting receive generous stipends.

Reimbursement and Health Care Issues

• PSG routinely corresponds with carriers to convey gastroenterology concerns and clarify questions.

• PSG sends a gastroenterology representative to the PA Medicare Carrier Advisory Committee.

PSG Website The PSG Website (www.pasg.org) has many features that benefit our physician members and their patients.

Website features include: • membership information – online join/renew opportunities; • meeting information; • legislative and payor relations updates; • fellows in training details; and • electronic copies of the PSG newsletter, Rumblings.

Rumblings Newsletter • • • •

Contains reimbursement news and updates Alerts members of pending issues and problems relative to gastroenterology Informs members of state and federal legislative issues effecting Pennsylvania gastroenterologists Provides helpful information for GI fellows and new practitioners

If you received this issue of Rumblings as a non-member, PSG invites you to consider membership benefits such as free registration for the PSG Annual Scientific Meeting, representation in physician advocacy activities, and opportunities for dialogue with other GI professionals across Pennsylvania. To learn more about the Society, visit www.pasg.org.

Join us today! A membership application is enclosed.

7 Digestive Disease National Coalition Report

By Ralph D. McKibbin, MD, FACP, FACG, AGAF DDNC Representative The Digestive Disease National Coalition (DDNC) 27th Annual Public Policy Forum was held on March 5th and 6th, 2017 at the Phoenix Park Hotel in Washington, DC. As the PSG representative, I pushed the interests of patients and physicians from Pennsylvania.

I also chaired the meetings in my role as President of the DDNC. More than 150 patient advocates, gastrointestinal physicians, and industry representatives attended. Updates were provided by a panel of selected federal agency and key legislative speakers. Topics included cutting edge advances in digestive disease research, healthcare reform priorities, and a preview of the CDC’s Division of Viral Hepatitis prevention activities. Approximately 120 visits were performed on Capitol Hill to advocate for the DDNC’s legislative priorities, including federal research funding for NIH and advocating for basic patient protections of the Affordable Care Act. The three key priorities of the DDNC Public Policy Agenda are research, patient access to care, and prevention & awareness. Attendees also heard a legislative overview and received an advocacy training session from DDNC’s Washington Representative, Dale P. Dirks. Additionally, the American Gastroenterological Association hosted a dinner and listening session for state GI society leaders and representatives from around the country. This meeting was facilitated by the AGA as part of their listening initiative and allowed networking with other state leaders to share best practices and explore common issues as well as giving input into the national agenda. This was a great discussion for everyone involved.

The DDNC presented its Congressional Distinguished Public Service Awards to Senators Bill Cassidy, M.D. (R-LA) and Patty Murray (D-WA). Madeleine Pannell accepted the award on her behalf. Senator Cassidy was able to accept the award in person and stayed to speak with many of our attendees. Senator Cassidy is a gastroenterologist turned legislator and his insights were appreciated.

(L to R) Dr. Ralph McKibbin, Senator Bill Cassidy, Dr. Jay Yepuri DDNC Congressional Distinguished Public Service Award presented to Senator Bill Cassidy

The DDNC presented its Lifetime Achievement Award to Jane Holt, treasurer for the DDNC and co-founder of the National Pancreas Foundation. Jane has been actively involved in the DDNC for over 20 years. Her invaluable contributions are well-deserving of this award, and we look forward to continuing our work with her for the foreseeable future.

Primed by the national debate on healthcare priorities, the DDNC held one of its most successful events yet. The PSG, through our representation in the DDNC, will continued to advocate for our legislative and policy priorities to Pennsylvania’s Federal Congressional legislative representative and the Administration. We will continue to keep our members updated on our progress in achieving these goals.

8 Legislative Update

Senate Bill 1202 (Act 124 0f 2016)

By Richard E. Moses, DO, JD Chair, PSG Legislative Committee The PSG, in cooperation with the PAMED and other state societies, continues to track healthcare bill legislation introduced into the Pennsylvania Congress. The PSG has made access to select bills available to members on the PSG website: www.pasg.org. This list of bills is periodically updated.

2017 is proving to be another very active year for the Pennsylvania Congress with the introduction of a number of healthcare related bills. We will touch on some of the major bills of interest to date including the Acts signed into law by Governor Wolf at the end of 2016.

For each licensure renewal period, physicians and other prescribers must complete at least 2 hours of education in pain management, identification of addiction, or the practices of prescribing or dispensing opioids. For initial licenses, 4 hours of education are required. At least 2 of these hours must be in pain management or identification of addiction and at least 2 hours of education in the practices of prescribing or dispensing opioids. This mandatory training may be counted towards the 100 hours of the total CME necessary for biennial license renewal.

Prescribers must query the Prescription Drug Monitoring Program (PDMP) system each time a patient is prescribed an opioid drug product or benzodiazepine. Dispensers must query the PDMP system before dispensing an opioid drug product or a benzodiazepine prescribed to a patient under certain circumstances.

Senate Bill 1367 (Act 125 of 2016) This law limits opioid prescriptions for minors to a 7-day duration when consent is given by a minor’s parent or legal guardian, except in medical emergency cases, chronic pain

Now Enrolling for ELAD Clinical Trial Assessing Survival in Subjects Diagnosed with Acute Alcoholic Hepatitis ®

VTL-308 Study Overview and Enrollment Sites: www.AAHStudy.com VTL-308: A Phase 3, Randomized, Open-Label, Multicenter, Controlled, Pivotal Study to Assess Safety and Efficacy of ELAD® in Subjects with Alcohol-Induced Liver Decompensation (AILD)

The primary objective of the study is to evaluate safety and efficacy of ELAD® with respect to overall survival (OS) of subjects with a clinical diagnosis of alcohol-induced liver decompensation (AILD) through at least Study Day 91.

Key Eligibility Criteria*:

• Age 18 to <50 • Bilirubin ≥16 mg/dL (273.6 μmol/L) • INR ≤2.5

• Serum Creatinine <1.3 mg/dL (115.04 μmol/L) • MELD score <30

• Maddrey score ≥32 • Association (6 weeks or less) of alcohol use and hospital admission for this episode of AILD

*Although subjects may meet the criteria above, they may not qualify for VTL-308. Please visit www.clinicaltrials.gov for full inclusion/exclusion criteria and for more information about participation.

For more information, please contact Brian Dempster or Michael Stephens at clinicaltrials@vitaltherapies.com or at 858-673-6840 ELAD is an investigational extracorporeal, human cell-based liver treatment, and is designed to improve survival of subjects with liver failure by providing hepatic support continuously for up to five days.

Sponsor: Vital Therapies, Inc.

For more information please visit www.aahstudy.com or www.clinicaltrials.gov.

NCT#02612428.

The ELAD System has not been demonstrated to be safe or effective for any indication and is not available for sale in the United States or any other country. CAUTION: Investigational Product.

Limited by United States law to investigational use.

Copyright ©2008-2017 Vital Therapies, Inc. All rights reserved. AD-000002-0117 v05

(858) 673-6840 | www.vitaltherapies.com

9 management, cancer treatment, and for palliative or hospice care. The law limits opioid prescriptions for minors to a 72hour dose when an authorized adult, as opposed to a minor’s parent or legal guardian, is available to consent for the minor patient.

Prescribers are required to obtain written consent for the prescription from the minor’s parent or guardian or from an authorized adult. The form must then be maintained in the minor’s medical record with the prescriber.

Act 125 required state licensing boards to create the consent form that prescribers need in order to comply with the law.

The Bureau of Professional and Occupational Affairs recently approved the consent form. The form was made available to prescribers in early February. It is available online at http://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/ Documents/Act%20125-Consent%20to%20Prescribe%20Opioid%20 Medication%20to%20Minor%2020170123.pdf.

Senate Bill 1368 (Act 126 of 2016) This law establishes a safe opioid prescribing and pain management curriculum in medical schools and medical training facilities. It also allows a patient to sign a form prohibiting the prescribing or administrating of a controlled substance containing opioid to that patient.

House Bill 1699 (Act 122 of 2016) This law limits the prescribing of an opioid product to an individual seeking treatment in certain settings (an emergency department, urgent care center, or an individual who is in observation status in a hospital), to no more than a quantity sufficient to treat that individual for up to seven days. As an exception, a health care provider may prescribe more than a seven-day supply to treat a patient’s acute medical condition or if it is deemed necessary for the treatment of pain associated with cancer diagnosis or for palliative care.

The Pennsylvania Medical Society has a comprehensive fact sheet available discussing these four opioid laws. It is available at www.pamedsoc.org/quickconsult. Over 50 other bills have been introduced into the Pennsylvania House and Senate to address the opioid addiction crisis. The PSG is following them accordingly.

PA Prescription Drug Monitoring Program (PDMP) As a reminder, the PSG again calls your attention to recent launching on August 25, 2016 of the Pennsylvania PDMP (PA

PMP AWARxE). Pennsylvania physicians who are licensed, registered, or otherwise lawfully authorized to prescribe controlled substances in the course of professional practice or research in Pennsylvania, are required by law to register in PA PMP AWARxE. The link is https://pennsylvania. pmpaware.net/login.

By law, prescribers must query the system for each patient every time the patient is prescribed a controlled substance (opioid or benzodiazepine) for purposes of establishing a baseline and a thorough medical record. A prescriber shall also query the system if he/she believes or has reason to believe, using sound judgement, that a patient may be abusing or diverting drugs.

To make consistent use of the PA PDMP more practicable, prescribers and dispensers may grant access to any delegates under their employment or supervision to query the system on their behalf. Delegates register for their own accounts and enter the email address of their supervising prescriber(s) or pharmacist(s) to request access to the database.

Further information may be obtained at: http://www.health. pa.gov/Your-Department-of-Health/Offices%20and%20Bureaus/ PaPrescriptionDrugMonitoringProgram/Pages/PDMP-Portal. aspx#.V_qRNCvD-Uk.

Senate Bill 25 (2017) In late February of this year, SB 25 was introduced which pertains to certified registered nurse practitioners (Camera Bartolotta, R-Washington). This bill amends the Professional Nursing Law further providing for definitions for the State Board of Nursing; for dietician-nutritionist license required; for temporary practice permit; for graduates of schools of other states, territories or Dominion of Canada; for certified registered nurse practitioners; for scope of practice for certified registered nurse practitioners; for prescriptive authority for certified registered nurse practitioners; for Drug Review Committee and for professional liability; and providing for the expiration of the State Board of Nursing’s power to license certified registered nurse practitioners.

As of this writing, the SB 25 was referred to the Senate Committee on Consumer Protection and Professional Licensure. It is believed a Committee vote will be called for late March or April of this Congressional session.

10 PAMED Specialty Leadership Cabinet Report

By Manish Thapar, MD SLC Representative The Specialty Leadership Cabinet (SLC) met on January 31 in Harrisburg. Marty Raniowski, PAMED’s new executive vice president was introduced by SLC Chair, John Gallagher, MD and provided an overview of his background and goals for PAMED. The SLC discussed several collaborative opportunities on various issues affecting our practices and healthcare. Items addressed included: A. Maintenance of Certification. Drs. Cutler and Shapiro presented an overview of the ABIM and discussed strategy and goals moving forward. Dr. Mackay, from the Plastic Surgery Specialty, discussed their efforts to provide MOC. Drs. Cutler and Shapiro requested SLC representatives to discuss with their leadership supporting the PAMED No-Confidence Letter.

B. Out-of-Network Billing. Dr. Carter (PACEP) and Dr. Martin (PSA) provided an update on the outof-network billing issue and steps taken by PACEP, PSA, PAP and PSR. Documentation was provided for informational purposes. The four specialty groups plan to meet prior to the May SLC meeting and may be requesting support from the SLC on potential legislation.

C. Sterile Compounding. Dr. Kalman (PAAA) reviewed the informational materials provided regarding the sterile compounding issue. PAD and PAO are also involved in this issue. After the SLC meeting the Board of Pharmacy released draft regulations on compounding for review and comment. Comments were due to the BOP by April 10.

D. Maintaining Coverage for Women’s Healthcare: Dr. Coslett-Charlton (PA ACOG) reviewed the impact of the potential abolishment of the ACA under the new administration and how it would affect access to healthcare for women. PA ACOG requested PAMED strongly support retention of all benefits to women’s health as stipulated in the ACA, including but not limited to, maternity care coverage, contraceptive coverage, cancer screening, and preservation of access to care in the Commonwealth of Pennsylvania.

The specialty representatives heard from PAMED’s legal, regulatory affairs, and legislative departments on various issues being monitored. Mike Siget, regulatory affairs counsel for PAMED, updated the SLC on department of health issues including the Achieving Better Care by Monitoring All Prescription Programs (ABC-MAP) Act, immunization regulations, healthcare worker ID badge regulations and medical marijuana regulations. Other updates included the Department of State’s internship requirements, laser regulations, child abuse reporting requirements, osteopathic prescribing, anesthesia, and compounding regulations.

Dave Thompson highlighted the outcome of several legislative bills PAMED was monitoring during the 20152016 session. Bills passing during the session included the Hep C and Oral Chemotherapy Parity bill. Bills not successfully passed during the session and most likely being re-introduced in the 2017-2018 session were also discussed. PAMED’s legislative focus will be on prior authorization legislation, credentialing, telemedicine, and POLST. To view current legislation in both the Senate and House, visit http://www.legis.state.pa.us.

The SLC will meet again on May 16 with Representative Mark Mustio (R-Allegheny) as a guest speaker. Rep. Mustio represents parts of Alleghany County, has been a representative since 2003 and is the current chair of the Professional Licensure Committee and serves on the Committee on Committees and the Liquor Control Committee.

Welcome New Members (November 1 through March 27, 2017)

Active Bradley Confer, DO Associate Mitchell Kang, DO Ryan Urbas, DO

11 President’s Message continued from page 1

societies of gastroenterology. This meeting was facilitated by the AGA as part of their listening initiative and held in conjunction with the Digestive Disease National Coalition annual public policy forum in Washington, DC. The meeting was a great success and allowed networking with other state leaders to share best practices and explore common issues but also to have input into the national agenda. While many issues facing state societies were discussed, the “hot” item was MOC. While I do not wish to misrepresent the feelings of others, I can clearly state that despite the recent changes, there were no positive comments voiced during the very heated discussion.

Over and over the state leaders detailed the negative impact on the ability of gastroenterologists to perform their jobs. In this time of national debate over spending and healthcare priorities, it will be easy for MOC to be overlooked, trivialized, and efforts for reform deferred. If we do not continue our efforts now, we will have a much harder time in the future. This should not be allowed to happen. As in all policy debates, the voices of those affected need to be heard. While PSG, ACP, PAMED, AGA, ACG, and ASGE are active on the issue, it is important that we keep this issue “live.” I am asking all PSG members to contribute to continued MOC reform by doing the following things.

1. Send an email of support for reform to the PSG leadership. This empowers us to push for reform.

2. Contact PAMED and express support for their leadership and efforts on MOC reform.

3. Contact your ACG governors and ask them to advocate for you on this issue.

4. Send letters of support for MOC reform to the AGA and ASGE asking them to continue their efforts.

5. Contact the ABIM and express your dissatisfaction over the MOC process that is expensive, burdensome, and not evidence based.

Board certification is something we are all proud of. It is a symbol of our exhaustive efforts to achieve expertise in our field. It proclaims to all the high level of care that we provide to our patients. It should not be allowed to stay an expanding, expensive, and time-consuming burden which detracts from our ability to provide the best care to our patients.

PSG

PRSRT STD U.S. POSTAGE PAID HARRISBURG PA PERMIT NO. 922

777 East Park Drive PO Box 8820 Harrisburg, PA 17105-8820

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PSG

PSGâ&#x20AC;&#x2122;S ANNUAL SCIENTIFIC MEETING SEPTEMBER 8-10, 2017 Nemacolin Woodlands Resort | Farmington, PA

Visit www.nemacolin.com for destination details Watch your mail in June for the registration brochure! www.pasg.org