Dear Colleagues,

I hope all of you are having a wonderful summer. I’d like to take a moment to share some new developments impacting women’s health research and the practice of urogynecology that merit our attention and action.

A new proposed framework to reorganize the NIH and implement new policies related to NIH funding and grants was released last month by the House Energy & Commerce Committee. The Framework for NIH Reform reduces the number of NIH Institutes and Centers from 27 to 15, including moving the NICHD into a new National Institute for Disabilities Related Research and renaming and restructuring the NIA as the National Institute of Dementia. The framework also proposes numerous policy changes such as giving Congress authority to direct NIH funding and limiting grants and awards only to primary investigators who do not have more than three ongoing concurrent NIH engagements. AUGS is developing a response to the House Energy & Commerce Committee’s request for comment.

While the opportunity to consider how NIH can create efficiencies and maximize federal research dollars is welcomed, this must be done through an open and thoughtful process with the input of the biomedical research community. Unfortunately, the House decided to move forward with the proposed NIH framework, before receiving any input, by inserting the NIH framework in the FY 25 Labor-HHS appropriations bill that is moving through the House. This premature and unwarranted action must be stopped! Many of you will receive an AUGS Action Alert email today requesting that you contact your Representative to oppose further action on the NIH framework until it can be appropriately considered and vetted. Please take a moment to complete this essential work.

Another important topic is the Calendar Year (CY) 2025 Medicare Physician Fee Schedule (MPFS) proposed rule that was released by CMS on July 10th. Once again, the proposed rule contains a payment cut in CY 2025, by decreasing the conversion factor (CF) by approximately 2.8% --from $33.28 to $32.35. Unfortunately, these cuts coincide with ongoing growth in practice costs. CMS projects the increase in the Medicare Economic Index (MEI) for 2025 will be 3.6%.

Also of note, the rule contains proposals related to the 90-day global surgical packages intended to improve global surgery payment accuracy. CMS is proposing to require the use of an appropriate transfer of care modifier (modifier -54, -55, or -56) for all 90-day global surgical packages when a physician plans to provide only a portion of a global package, including when there is a formal, documented transfer of care or an informal, non-documented but expected transfer of care. Additionally, the rule proposes establishing a new E/M add-on code, GPOC1, to be billed for post-operative follow-up care during the global period of a global package. This new add-on code would help capture additional time and resources spent providing post-operative care by a physician who did not perform the surgical procedure and who has not been involved in a formal transfer of care agreement. CMS proposes that this code could be billed only once during the 90-day global period. The AUGS Coding Committee is assessing the impact of these proposals and others in the 2,000 pages of the MPFS rule and will be developing the AUGS comment letter for submission in September.

You can learn more about Medicare payment policy by joining an AMA webinar on the “Fix Medicare Now” campaign on Thursday evening, August 1st. The webinar will review the current state of federal Medicare reform legislation and ongoing advocacy efforts. More information about the webinar can be found here.