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We are seeing Cigna and other payers downcoding our claims. These were level 4 claims submitted with diarrhea, GERD, IBS, etc. What can we do to prevent this?
A 62-year-old, Caucasian male presents for a 6-month history of nausea and abdominal discomfort. He reports a 10-year history of heartburn at least 4 times per week, taking calcium carbonate for relief.
Is driving smarter capacity planning in 2026 part of your team’s playbook? Read on for responses from ASGE committee members who share their plans for stronger performance in the New Year.
CMS launched the MAHA ELEVATE Model, a new Medicare value-based payment model supporting evidence-based whole-person care, including lifestyle and functional medicine. Up to 30 awards will fund data collection on these interventions starting in 2026.
All 50 states will receive a share of $50B in rural health funding over five years under the One Big Beautiful Bill Act. Funds are split evenly and by rural need, and CMS created a new Office of Rural Health Transformation to oversee the program.
CMS is seeking applicants for the voluntary ACCESS Model, testing technology-supported care for chronic conditions. The model emphasizes outcome-based improvement and provides recurring payments tied to measurable health results.
CMS announced the voluntary BALANCE Model to expand coverage of GLP-1 drugs for weight management, pairing medications with free lifestyle support. Coverage depends on participation, with Medicaid launching in 2026 and Medicare Part D in 2027.
CDC will delay the first hepatitis B vaccine to 2 months for infants born to HBV-negative mothers, while keeping the birth dose for infants of positive or unknown status. The change follows ACIP guidance, and parents may still choose earlier vaccination.
ASGE members should be aware of an upcoming deadline affecting Medicare telehealth services. Current telehealth flexibilities are scheduled to expire on January 31, 2026, unless Congress acts to extend them.
ASGE, AGA, and ACG sent a joint letter to CMS urging a delay of proposed Practice Expense changes until specialty-specific analysis is completed, warning of unintended impacts on endoscopy services.
I feel extremely fortunate to have received this invaluable, once-in-a-lifetime opportunity provided by the American Society for Gastrointestinal Endoscopy (ASGE) and FUJIFILM Medical Systems U.S.A., Inc.
Mark your calendars for education designed for trainees at every stage of fellowship hosted at the ASGE Institute for Training and Technology facility in Downers Grove, IL and/or participate virtually.
Calling all early-career ASGE members worldwide! Prepare now to apply for the 2026 ASGE Endoscopic Training Award and take your GI endoscopy skills to the next level by training with leading endoscopists at top institutions, internationally or in the U.S.
Patient and provider groups are urging passage of the FY 2026 Defense Spending bill to ensure full funding for the CDMRPs, which includes the Peer Reviewed Cancer Research Programs, an important source of funding for GI-related cancer research.
ACIP voted to end universal birth-dose hepatitis B vaccination, recommending the first dose at two months for infants of hepatitis B–negative mothers. Only infants of positive or unknown-status mothers get the birth dose. ASGE joined AASLD opposing this.