American Gastroenterological Association calls on Congress to reduce prior authorizations, improve reimbursements

The American Gastroenterological Association, which represents more than 16,000 physicians nationwide, spent Sept. 26 working with Congress to make changes to GI patient care. 

AGA brought together 100 members and patient advocates from 28 states for its annual Advocacy Day, according to a Sept. 26 news release sent to Becker's. 

AGA focused on five key issues that are mainly affecting surgeons, including prior authorization, guardrails on step therapy, blocking Medicare reimbursement cuts, stopping efforts to restructure the National Institutes of Health and increasing digestive disease funding to the NIH. 

  1. The AGA supported the Improving Seniors’ Timely Access to Care Act, which aims to increase transparency for prior authorization and streamline the process under Medicare Advantage.
  2. The organization believes that step therapy jeopardizes the physician-patient relationship, since it bypasses what the physician believes is the best treatment for patients. Advocates called on lawmakers to support The Safe Step Act, which would provide a clear and timely appeals process when a patient has been subjected to step therapy.
  3. Currently, multiple pieces of legislation in Congress address ongoing Medicare payment cuts. The AGA is asking Congress to address the 2.8% cut and explore more permanent solutions to Medicare physician reimbursement.
  4. The AGA opposes restructuring of the NIH. Advocates have urged Congress to go through regular order before considering reforming NIH. 
  5. Lastly for fiscal year 2025, AGA advocates also asked Congress to give the NIH $51.3 billion, grant $1.05 billion in Veterans Administration medical research funding, continue funding GI disease research  in the Congressionally Directed Medical Research Program and for the creation of a colorectal cancer research program as a separate item from CDMRP, to be funded at $20 million. 

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