Will endoscopic global fees destroy gastroenterology as a specialty?

The Health Care Financing Administration (HCFA) has recently proposed a plan, effective July 1, 1991, for Medicare to pay for endoscopic procedures according to a global fee arrangement. Under global fees, the charges for any hospital or office visits for 30 days after endoscopy will be considered to be included in the Medicare payment for the endoscopic procedure. Global endoscopy fees depreciate the nonprocedural aspects of the gastroenterologist's care. In concert with other physician income reduction provisions of the 1989 and 1990 Omnibus Budget Reconciliation Acts, global endoscopy fees will dramatically alter the future behavior of gastroenterologists and their attitude toward Medicare patients. The deadline for writing HCFA has passed, but concerned gastroenterologists should protest this plan at once to their Senators and Congressional Representatives.