ACG Advocacy Successful on Multiple Fronts: Congress Includes Various ACG Priorities in Two-Year Budget

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    Thank you ACG members for your advocacy. While there is much more to do, your efforts have paid off on multiple fronts.

    This week Congress passed a two-year budget deal, along with a “continuing resolution” to keep the federal government open past February 9. This two-year budget agreement also includes various ACG public policy priorities that we advocated for over the past year. ACG appreciates all of your efforts! Please find below a summary of the various ACG priorities incorporated into this legislation.

    MIPS Cost Performance Category

    As part of this budget deal, Congress provides CMS the regulatory authority to lower/revise the MIPS Cost performance category an additional three years. This helps ease the transition into MIPS for another three years and helps reduce the threat of Medicare reimbursement cuts. ACG recently urged congressional leadership to include this language in any continuing resolution package. ACG Governors advocated for a change in the MIPS Cost performance category with policymakers back in April 2017. This was the first time many members of Congress and staff became aware of the problem.

    Why is this important to ACG members? When Congress passed MACRA in 2015, it provided CMS with flexibility to implement MIPS in only the first two years of the program. This may have major consequences, especially in the MIPS Cost performance category. This performance category is designed to measure and compare the costs of your physician services versus other providers performing the same services. Thankfully, this category had no impact on your final MIPS score in 2017 (weight of 0%). Yet, it will make up 10% of your final MIPS score in 2018. Absent a change, MACRA required CMS to increase this weighting to 30% of your total MIPS score beginning next year. Without these necessary legislative and regulatory changes, 30% of your total Medicare reimbursement will be based upon cost metrics which, according to CMS, have only “moderate” reliability. We need CMS to change the performance weights as we transition into MACRA, and CMS needed the regulatory authority to do this.

    Repeals IPAB

    ACG has urged Congress to repeal the Independent Payment Advisory Board (IPAB) since this was first authorized in the Patient Protection and Affordable Care Act (known as the ACA) in 2010, and during the most recent attempts to repeal the ACA. The IPAB is designed to come up with cost savings (physician reimbursement cuts) whenever the Medicare Part B program’s actual costs are higher than targeted. The ACA also required CMS to implement these cuts. While never fully operational, the IPAB served as a looming threat to our Medicare reimbursement and our practices.

    Medicaid Funding for Puerto Rico

    Congress will provide $4.9 billion for two years of disaster relief Medicaid funding for Puerto Rico and the U.S. Virgin Islands, and will provide 100% of the federal match for Puerto Rico’s Medicaid program. ACG appreciated that the house of medicine supported ACG’s resolution for more advocacy on behalf of Puerto Rico and the U.S. Virgin Islands in November 2017. ACG continued to advocate for these necessary Medicaid funds into 2018 as well.

    ACG will Continue to Fight for Clinical GI

    ACG will continue to advocate on behalf of clinical GI and our patients. I will also be in Washington, DC in April, joining the ACG Board of Governors as we visit members of Congress on your behalf. While there is still much to do, I wanted to personally thank ACG members for your efforts and advocacy.


    Irving M. Pike, MD, FACG
    ACG 2017-2018 President

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