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What's up in Washington that will affect your practice

Win for IBD patient care: BCBS rescinds policy to restrict IBD medications

AGA, ACG, ASGE and NASPGHAN recently sent a letter to Blue Cross and Blue Shield of Texas, Illinois, Montana, New Mexico and Oklahoma, to urge them to amend their proposed policy on “infliximab and associated biosimilars,” which would force many stable patients to switch medications. Our societies urged the insurers to provide exceptions for those patients who are stable on their current drug so as not to disrupt treatment.


Our advocacy efforts, along with the Biosimilars Underwater Coalition, of which AGA and the GI societies are members, were successful: Health Care Services Corporation (HCSC), the parent company of the BCBS plans, reversed their decision to implement the policy on Jan. 1, 2025.  


We will continue to monitor this and other payor policies that make medical decisions for patients

Sen. Cassidy selected to chair HELP Committee

Sen. Bill Cassidy, MD (R-LA), has been selected to lead the Senate Health, Education, Labor, and Pensions (HELP) Committee during the 119th Congress. This committee has jurisdiction over healthcare related issues. Sen. Cassidy is one of our congressional champions and the only gastroenterologist in Congress. He will be the first medical doctor to serve as Chair of this powerful committee since 1933.

2024 election round up

Republicans regained control of the White House and Senate, while also maintaining a very thin majority in the House of Representatives. They will need to work across the aisle to get legislation passed in the 119th Congress.  


AGA is committed to working with our congressional champions to advance our priorities that will further patient care and give decision-making power back to physicians.


What’s next for the lame duck session post-election? 


Congress has a number of issues to address before the end of the 118th Congress, including: 

  • Federal funding: The current continuing resolution (CR) set to expire on Dec. 20. Congress needs to pass another CR or fund the federal government to prevent a shutdown.  
  • Telehealth: Medicare coverage of telehealth flexibilities is set to expire at the end of 2024 unless Congress passes an extension.  
  • Medicare reimbursement: GI payments are set to be cut by at least 2.8% on Jan. 1, 2025, unless Congress intervenes.  

AGA will monitor these issues as the lame duck continues.  

Drs. Gruss & Perera represent AGA at the House of Delegates interim meeting

This month, American Medical Association (AMA) held its Interim Meeting. The policymaking body represents the interests of physicians and establishes health, medical, professional, and governance policies.  


AGA Government Affairs Committee members Claudia Gruss, MD, and Lilani Perera, MD, served as AGA’s delegates and informed the work of the HOD as they passed resolutions on the following topics, plus many more:  

  • Boost aging patients’ meaningful access to health tech 
  • Make sure doctors can intervene on AI-influenced health decisions 
  • Make sure health plans pay for care after prior authorization approval 

A special thank you to Dr. Gruss for leading the Digestive Disease Section Council (DDSC) of over 30 delegates, representing six GI-related specialty societies and state gastroenterologists, plus colon, rectal and bariatric surgeon delegates as they worked to focus the HOD on GI-related issues. Under her leadership, the DDSC has expanded its membership and influence at HOD.  

Grassroots Spotlight

Help stop Medicare payment cuts!


Gastroenterology Medicare payments are set to be cut by at least 2.8% on Jan. 1, 2025, unless Congress intervenes.    


We are committed to pushing Congress to address Medicare payment reimbursement but need you to lend your voice. Join us in urging your Member of Congress to act now to prevent harmful cuts that could reduce Medicare patients’ access to specialty care.  

Act now

PAC Corner

AGA welcomes new health professionals in 119th Congress

We gained six new healthcare professionals for the 119th Congress during the election. These providers know our issues firsthand and understand the burdens that you face on a daily basis.  


AGA PAC has already begun establishing relationships with these new members, including supporting Herb Conaway, MD. This summer, Dr. Conaway, a Democrat from New Jersey, reached out to AGA staff to learn more about our advocacy efforts. With approval from the PAC Board, we attended a fundraiser for him with other medical societies. 

AGA PAC looks forward to working with Dr. Conaway and the other newly elected healthcare professionals in the 119th Congress! 

Learn more

Regulatory Updates

CMS 2025 Payment Rules Finalize Physician Payment Cuts for Medicare 

The final 2025 Medicare Physician Fee Schedule and the Hospital Outpatient Prospective Payment System (OPPS)/Ambulatory Surgical Center (ASC) rules were released on Nov. 1.


GI faces a 2.8% cut to physician payments, barring Congressional action, while hospital and ASC payments will increase 2.9%.  


The final rules largely reflect CMS’ proposals from July.

  • COVID-19 telehealth flexibilities will end at the end of CY 2024.  
  • CMS did not accept new telemedicine office visit codes.
  • Expanded colorectal cancer (CRC) screening.
Key takeaways for GI

Post of the month

Hill Meetings

Rep. Jodey Arrington (R-TX) 

Rep. Cliff Bentz (R-OR) 

Sen. Katie Britt (R-AL) 

Rep. Debbie Dingell (D-MI) 

Rep. Tom Emmer (R-MN) 

Rep. Mark Green (R-TN) 

Rep. Michael Guest (R-MS) 

Rep. Marcy Kaptur (D-OH) 

Rep. Anna Paulina Luna (R-FL) 

Rep. Andy Ogles (R-TN) 

Rep. Greg Steube (R-FL) 

Click here to learn more about our advocacy efforts and issues impacting the GI community.  
  
Kathleen Teixeira 
Vice President of Public Policy and Advocacy

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