ABOUT GIPAC

GIPAC is the political action committee (PAC) for gastroenterologists. We are a bipartisan federal PAC that supports legislators demonstrating an interest in the issues and challenges facing gastrointestinal specialists and their patients. GIPAC also contributes to campaigns that are expected to be in competitive races in order to leverage support in the future and to campaigns recommended by GIPAC members. It is important to note that GIPAC is an issue-specific PAC: While our members may have diverse political opinions, we agree that it is important to support certain candidates who support those issues important to our profession.

GIPAC is always looking for more support on Capitol Hill. If you wish to have GIPAC support a campaign for federal office, please contact GIPAC leadership.

GIPAC has been actively involved in the campaign season leading to the elections later this year. With the passage of health reform, and the forthcoming regulations stemming from the health reform legislation, support for GIPAC is more crucial than ever. To this end, GIPAC has recently participated in events for Rep. Tom Price, M.D. (R-GA), Rep. Earl Pomeroy (D-ND), Sen. Ron Wyden (D-OR), and Sen. Kristin Gillibrand (D-NY). GIPAC will be actively involved in campaigns leading up to the fall 2010 elections.

Please visit http://GIPAC.org to make a contribution.
Also see below for a comparison of funds raised by GIPAC and other medical PACs in 2008 and 2009.

Paid for by Gastrointestinal Political Action Committee (GIPAC) and not authorized by any candidate or candidate's committee. Contributions are not deductible for Federal income tax purposes.

Please note: Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and the name of employer of individuals whose contributions exceed $200 in a calendar year.

Your personal check should be made payable to GIPAC. Contributions to GIPAC will be used in connection with federal elections. Contributions are strictly voluntary and are not limited to the suggested amounts, however, there is a limit of $5,000 from an individual per calendar year. Contributions from foreign nationals and corporations are prohibited. Contributions to GIPAC are not tax deductible for federal tax income purposes.

UPDATE FROM WASHINGTON D.C.

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (H.R. 3590, or “PPACA”) into law, P. L. 111-148. On March 30, 2010, the President signed into law the Health Care and Education Reconciliation Act of 2010 (H.R. 4872, or “Reconciliation Act”), P. L. 111-152, which made certain politically-required modifications to PPACA.

So what does this mean for gastroenterologists? While health reform legislation is now law, implementing health reform will have a profound effect in determining the impact on our specialty. In many respects, health reform has just begun.

The legislation fails to address the existing flaws in Medicare physician reimbursement and the sustainable growth rate (SGR) formula. In other legislative vehicles, Congress has delayed the 21 percent reimbursement reduction scheduled to go in effect January 2010 with temporary one-to-two month patches. However, as long as the current reimbursement system is in place, delaying the 21 percent cut only exacerbates the cuts in the future. Congressional leaders have said that they will attempt to place a moratorium on SGR cuts in separate legislation; unfortunately, making a permanent fix to this problem unlikely in the near future due to the significant budgetary cost and the lack political appetite for more health care legislation.

The goal of health reform legislation is to increase access to high quality and cost-effective health care. However, providers should be wary as to how the law will determine “cost-effective” health care.

Some highlights:

The law requires the Secretary to adjust reimbursement for certain physicians by a “value-based modifier” in 2015, which will adjust Medicare physician payments in a budget-neutral manner based on the quality and cost of the care they deliver. By January 2017, this provision will apply to all physicians and physician groups.
The new health reform law also requires the Secretary to review and adjust reimbursement for certain “misvalued” codes, including codes experiencing high volume growth. This provision could have significant consequences for providers performing colonoscopy and colorectal cancer screening as other provisions in the law aim to increase screening utilization rates.
The newly authorized Independent Payment Advisory Board (IPAB). The IPAB will be a 15-member board tasked with presenting Congress with comprehensive proposals to reduce excess cost growth and improve quality of care for Medicare beneficiaries beginning 2014. In years when Medicare costs are projected to be unsustainable, i.e., greater than a target growth rate, the Board will be required to submit proposals to Congress that will become law unless Congress passes an alternative measure achieving the same level of savings. The Board is prohibited from making proposals that “ration care,” raise taxes or Part B premiums, or change Medicare benefit eligibility, or cost-sharing standards. Moreover, the Board is prohibited from recommending polices impacting payments for hospice and hospitals before 2018. However, there is no restriction on the Board from modifying physician reimbursement rates beginning 2014.

Ambulatory surgical centers (ASCs) and physician-ownership issues also are impacted by health reform. Effective January 2011, the Secretary is required to develop a plan to reimburse ASCs based on value and efficiency. It is unclear what data the Secretary will use when implementing a “value-based purchasing program” when determining a reimbursement “productivity adjustment.” ASC payments are currently pegged to a percentage of the hospital outpatient department (HOPD) payment rate, with GI services in the ASC setting reimbursed at roughly 59-60 percent of the HOPD rate. Additionally, the IPAB can also propose and implement policy changes affecting ASC procedures and reimbursement rates.

There is also a prohibition on new physician-owned hospitals from participating in the Medicare program entirely. Existing physician-owned or physician-invested facilities will be subject to greater scrutiny as the law requires new compliance, reporting and audit policies to monitor physician ownership and investment.

As you can see, health reform and the forthcoming regulations will have a significant impact on practicing GI’s in the near future. What’s more, these provisions must be implemented in a “budget-neutral” manner, meaning that any increase in coverage or reimbursement in one area must be offset with a cut in another area. These ‘budget-neutrality’ policies will continue to pit one specialty against another. That is why it is imperative that the GI community be active on Capitol Hill and why GIPAC be prepared to protect our specialty and promote our patients’ access to GI services.

As always, GIPAC thanks you for your support. Please continue to help make GIPAC a voice on Capitol Hill.

Regards,

Harry Sarles, Jr., MD, FACG
President
GIPAC
GIPAC.org

PHYSICIAN POLITICAL ACTION COMMITTEE CONTRIBUTIONS

The following are some top medical related PACs and the money raised by each in 2008 and 2009. With more member support, GIPAC can move up this list and have an even stronger presence in Washington. (Figures compiled from FEC reports available at www.fec.gov.)

PAC	SPONSOR	Contrbutions Received by PAC
PAC	SPONSOR	2008	2009
American Society of Anesthesiologists PAC	American Society of Anesthesiologists	$1,168,513.10	$1,663,161.50
American Association. of Orthopedic Surgeons PAC	American Association. of Orthopedic Surgeons	$1,151,364.74	$1,598,807.34
American College of Radiology PAC	American College of Radiology Association.	$875,677.60	$1,133,662.74
National Emergency Medicine PAC	American College of Emergency Physicians	$923,943.32	$1,024,690.50
American Optometric Association. PAC	American Optometric Association.	$900,901.81	$858,862.13
CRNA PAC	American Association of Nurse Anesthetists	$642,535.96	$703,930.31
American Physical Therapy Association. PAC	American Physical Therapy Association.	$626,177.61	$689,646.93
National Community Pharmacists Association. PAC	National Community Pharmacists Association.	$685,119.05	$663,849.22
American College of Cardiology PAC	American College of Cardiology	$407,097.53	$541,899.30
American Nurses Association. PAC	American Nurses Association.	$407,370.79	$385,782.11
American Academy of Family Physicians PAC	American Academy of Family Physicians	$442,904.44	$340,493.37
American Chiropractic Association. PAC	American Chiropractic Association.	$177,974.72	$163,460.59
GIPAC	No Sponsor	$37,624.00	$47,425.96