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This month in the journal CHEST®
Editor’s picks
Original Research
Pilot Feasibility Study in Establishing the Role of Ultrasound-Guided Pleural Biopsies in Pleural Infection (The AUDIO Study). By Dr. I. Psallidas, et al.
Commentary
Sleep Apnea Morbidity: A Consequence of Microbial-Immune Cross-Talk? By Dr. N. Farre, et al.
Evidence-Based Medicine
Treatment of Interstitial Lung Disease-Associated Cough: CHEST guideline and expert panel report. By Dr. S. S. Birring, et al.
Editor’s picks
Original Research
Pilot Feasibility Study in Establishing the Role of Ultrasound-Guided Pleural Biopsies in Pleural Infection (The AUDIO Study). By Dr. I. Psallidas, et al.
Commentary
Sleep Apnea Morbidity: A Consequence of Microbial-Immune Cross-Talk? By Dr. N. Farre, et al.
Evidence-Based Medicine
Treatment of Interstitial Lung Disease-Associated Cough: CHEST guideline and expert panel report. By Dr. S. S. Birring, et al.
Editor’s picks
Original Research
Pilot Feasibility Study in Establishing the Role of Ultrasound-Guided Pleural Biopsies in Pleural Infection (The AUDIO Study). By Dr. I. Psallidas, et al.
Commentary
Sleep Apnea Morbidity: A Consequence of Microbial-Immune Cross-Talk? By Dr. N. Farre, et al.
Evidence-Based Medicine
Treatment of Interstitial Lung Disease-Associated Cough: CHEST guideline and expert panel report. By Dr. S. S. Birring, et al.
Upcoming CPT® Changes
Pulmonary, critical care, and sleep physicians often provide services to patients, as well as consultative services to other health-care professionals, without a patient being present. This can be done via telephone or electronic (internet or electronic health record) communications. Many are not aware that Current Procedural Terminology (CPT®) codes were published to describe and define the work involved in these services. In 2019, there will be additional CPT codes available for health-care workers to use for these non-face-to-face services.
Telephone services are reported using CPT codes 99441-99443 and may be used for evaluation and management (E/M) services provided by telephone for an established patient that do not result in a patient visit within the next 24 hours or are associated with an E/M visit from the last 7 days.
99441 Telephone evaluation and management service by a physician or other qualified health-care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M serv ice provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 11-20 minutes of medical discussion
99443 21-30 minutes of medical discussion
These codes may not be reported by a provider more frequently than every 7 days. The details of the service should be documented in the medical record.
If the E/M service is prompted by an online patient request, then CPT code 99444 can be used.
99444 Online evaluation and management service provided by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient or guardian, not originating from a related E/M service provided within the previous 7 days, using the internet or similar electronic communications network.
This code may be reported only every 7 days and can not be related to a previous E/M evaluation in the last 7 days or to a previous surgical procedure. The service includes all of the communication (eg, related telephone calls, prescription provision, laboratory orders) pertaining to the online patient encounter.
There are also CPT codes for Interprofessional Telephone/Internet/Electronic Health Record Consultations. These codes are used when one health-care provider requests the opinion and/or treatment advice of another provider (consultant) for either a new or established patient without face-to-face contact between the patient and the consultant.
99446 Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review.
99447 11-20 minutes of medical consultative discussion and review
99448 21-30 minutes of medical consultative discussion and review
99449 31 minutes or more of medical consultative discussion and review
These codes are not used if the consultant has seen the patient in a face-to-face encounter within the last 14 days or the consultation results in a transfer of care or other face-to-face service with the consultant within the next 14 days. In addition, greater than 50% of the service time reported must be devoted to the medical consultative verbal or internet discussion. The request and reason for telephone/internet/electronic health record consultation by the requesting health-care professional should be documented in the patient’s medical record. After an oral report from the consultant is provided to the treating/requesting physician, a written report should be documented in the medical record. Consultations of less than 5 minutes should not be reported.
As noted, CPT codes 99446-49 require an oral and written report. A new code is added for 2019.
99451 Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.
CPT code 99451 describes a consultative service lasting more than 5 minutes and requires only a written report to the requesting physician. This was added recognizing that oral communications do not always occur between healthcare professionals and may facilitate consultative services in geographic areas with no specialists available.
99452 Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes.
CPT code 99452 is reported for 16-30 minutes preparing for the referral and/or communicating with a consultant. If more than 30 minutes is spent by the treating/requesting healthcare provider, then one would use a prolonged services code (99358-59).
As with all coding and billing issues, review the CPT manual for parentheticals that describe coding rules not included in the code description. In addition, not all CPT codes are paid by all providers. Knowledge of payer policies is, therefore, important for appropriate reimbursement.
Pulmonary, critical care, and sleep physicians often provide services to patients, as well as consultative services to other health-care professionals, without a patient being present. This can be done via telephone or electronic (internet or electronic health record) communications. Many are not aware that Current Procedural Terminology (CPT®) codes were published to describe and define the work involved in these services. In 2019, there will be additional CPT codes available for health-care workers to use for these non-face-to-face services.
Telephone services are reported using CPT codes 99441-99443 and may be used for evaluation and management (E/M) services provided by telephone for an established patient that do not result in a patient visit within the next 24 hours or are associated with an E/M visit from the last 7 days.
99441 Telephone evaluation and management service by a physician or other qualified health-care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M serv ice provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 11-20 minutes of medical discussion
99443 21-30 minutes of medical discussion
These codes may not be reported by a provider more frequently than every 7 days. The details of the service should be documented in the medical record.
If the E/M service is prompted by an online patient request, then CPT code 99444 can be used.
99444 Online evaluation and management service provided by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient or guardian, not originating from a related E/M service provided within the previous 7 days, using the internet or similar electronic communications network.
This code may be reported only every 7 days and can not be related to a previous E/M evaluation in the last 7 days or to a previous surgical procedure. The service includes all of the communication (eg, related telephone calls, prescription provision, laboratory orders) pertaining to the online patient encounter.
There are also CPT codes for Interprofessional Telephone/Internet/Electronic Health Record Consultations. These codes are used when one health-care provider requests the opinion and/or treatment advice of another provider (consultant) for either a new or established patient without face-to-face contact between the patient and the consultant.
99446 Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review.
99447 11-20 minutes of medical consultative discussion and review
99448 21-30 minutes of medical consultative discussion and review
99449 31 minutes or more of medical consultative discussion and review
These codes are not used if the consultant has seen the patient in a face-to-face encounter within the last 14 days or the consultation results in a transfer of care or other face-to-face service with the consultant within the next 14 days. In addition, greater than 50% of the service time reported must be devoted to the medical consultative verbal or internet discussion. The request and reason for telephone/internet/electronic health record consultation by the requesting health-care professional should be documented in the patient’s medical record. After an oral report from the consultant is provided to the treating/requesting physician, a written report should be documented in the medical record. Consultations of less than 5 minutes should not be reported.
As noted, CPT codes 99446-49 require an oral and written report. A new code is added for 2019.
99451 Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.
CPT code 99451 describes a consultative service lasting more than 5 minutes and requires only a written report to the requesting physician. This was added recognizing that oral communications do not always occur between healthcare professionals and may facilitate consultative services in geographic areas with no specialists available.
99452 Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes.
CPT code 99452 is reported for 16-30 minutes preparing for the referral and/or communicating with a consultant. If more than 30 minutes is spent by the treating/requesting healthcare provider, then one would use a prolonged services code (99358-59).
As with all coding and billing issues, review the CPT manual for parentheticals that describe coding rules not included in the code description. In addition, not all CPT codes are paid by all providers. Knowledge of payer policies is, therefore, important for appropriate reimbursement.
Pulmonary, critical care, and sleep physicians often provide services to patients, as well as consultative services to other health-care professionals, without a patient being present. This can be done via telephone or electronic (internet or electronic health record) communications. Many are not aware that Current Procedural Terminology (CPT®) codes were published to describe and define the work involved in these services. In 2019, there will be additional CPT codes available for health-care workers to use for these non-face-to-face services.
Telephone services are reported using CPT codes 99441-99443 and may be used for evaluation and management (E/M) services provided by telephone for an established patient that do not result in a patient visit within the next 24 hours or are associated with an E/M visit from the last 7 days.
99441 Telephone evaluation and management service by a physician or other qualified health-care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M serv ice provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 11-20 minutes of medical discussion
99443 21-30 minutes of medical discussion
These codes may not be reported by a provider more frequently than every 7 days. The details of the service should be documented in the medical record.
If the E/M service is prompted by an online patient request, then CPT code 99444 can be used.
99444 Online evaluation and management service provided by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient or guardian, not originating from a related E/M service provided within the previous 7 days, using the internet or similar electronic communications network.
This code may be reported only every 7 days and can not be related to a previous E/M evaluation in the last 7 days or to a previous surgical procedure. The service includes all of the communication (eg, related telephone calls, prescription provision, laboratory orders) pertaining to the online patient encounter.
There are also CPT codes for Interprofessional Telephone/Internet/Electronic Health Record Consultations. These codes are used when one health-care provider requests the opinion and/or treatment advice of another provider (consultant) for either a new or established patient without face-to-face contact between the patient and the consultant.
99446 Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review.
99447 11-20 minutes of medical consultative discussion and review
99448 21-30 minutes of medical consultative discussion and review
99449 31 minutes or more of medical consultative discussion and review
These codes are not used if the consultant has seen the patient in a face-to-face encounter within the last 14 days or the consultation results in a transfer of care or other face-to-face service with the consultant within the next 14 days. In addition, greater than 50% of the service time reported must be devoted to the medical consultative verbal or internet discussion. The request and reason for telephone/internet/electronic health record consultation by the requesting health-care professional should be documented in the patient’s medical record. After an oral report from the consultant is provided to the treating/requesting physician, a written report should be documented in the medical record. Consultations of less than 5 minutes should not be reported.
As noted, CPT codes 99446-49 require an oral and written report. A new code is added for 2019.
99451 Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician, including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 minutes or more of medical consultative time.
CPT code 99451 describes a consultative service lasting more than 5 minutes and requires only a written report to the requesting physician. This was added recognizing that oral communications do not always occur between healthcare professionals and may facilitate consultative services in geographic areas with no specialists available.
99452 Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes.
CPT code 99452 is reported for 16-30 minutes preparing for the referral and/or communicating with a consultant. If more than 30 minutes is spent by the treating/requesting healthcare provider, then one would use a prolonged services code (99358-59).
As with all coding and billing issues, review the CPT manual for parentheticals that describe coding rules not included in the code description. In addition, not all CPT codes are paid by all providers. Knowledge of payer policies is, therefore, important for appropriate reimbursement.
Welcome Dr. Cowl!
As we greet our new CHEST President, Clayton T. Cowl, MD, MS, FCCP, we asked him for a few thoughts about his upcoming presidential year. He kindly offered these responses:
What would be one of the many things you would like to accomplish as President of CHEST?
We plan to increase the engagement of our membership, and, in do so, allow for more opportunities to serve in leadership roles, educate as faculty, or to participate in more of the wide array of educational opportunities within CHEST – whether the member is a long-tenured physician, a trainee, an earlier career researcher or educator, or a colleague in the care team, such as a respiratory therapist, advanced practice provider, or a pharmacist. CHEST has been and will continue to be a leader in delivery of education, and will further advance opportunities to present breaking research. Ultimately, the reason we are in medicine is to improve the care that we deliver to our patients, so it is incumbent upon us to keep the mission aimed toward “patient-centric” goals.
What do you consider to be the greatest strength of CHEST, and how will you build upon this during your Presidency?
Our greatest strength is our members, who bring a diversity of experience, expertise, and passion for what they do at the forefront. Together, with our incredibly talented and dedicated support staff at CHEST, as well as our industry and publishing partners, our organization is poised to bring medical education in pulmonary, critical care, and sleep medicine globally to the next level. The CHEST Foundation has stimulated important opportunities for research, increased the ability for younger members to attend meetings and actively engage in CHEST activities, and provided valuable information to patients in a language they can understand. Thanks to advances in technology, there are improved platforms for communicating with our membership and for delivering education in novel and more effective ways than ever before. We plan to double down on our strategic focus of utilizing innovation and new technologies to lead trends in education, influence health-care improvements for our patients and their families, and to deliver the latest in medical education to clinicians and investigators worldwide.
What are some challenges facing CHEST, and how will you address these challenges?
Many of our members are facing challenges in their practices – both domestically and internationally. Industry and employer-based sponsorship to attend meetings has declined, travel remains expensive, and time away from the practice has become more and more difficult for a variety of reasons. Our members are being challenged with greater regulatory and administrative burdens and are bombarded with the demands of work overload. In addition to working with other organizations to identify workplace burnout and, more importantly, to offer better solutions, we are focused on leveraging a variety of new technologies to bring our CHEST brand of quality education to all of our members, regardless of location, and to do so in a way that best suits individual needs. The traditional model of attending a large meeting comprised solely of didactic presentations is, frankly, becoming outdated. CHEST will continue to “tip the apple cart” of worn out educational delivery methods and look toward innovating courses that are more accessible, more effective and relevant, more affordable, and more fun.
And finally, what is your charge to the members and new Fellows of CHEST?
We have each been blessed with the opportunity to serve patients and their families in their times of need. Let’s not forget that privilege as we deliver care each and every day. The word “doctor” comes from an agentive noun of the Latin verb docēre (“to teach”). Regardless of where you practice, what your role is in the health-care paradigm, or whether your contribution is directly with patients or indirectly through research, education, or administration, we are all teachers in various ways to various people. That’s why the American College of Chest Physicians (CHEST) needs to listen to your needs, cultivate your collective wisdom, and continue to be the leading organization within our specialties for delivering medical education and, ultimately, for providing outstanding care and compassion to our patients.
As we greet our new CHEST President, Clayton T. Cowl, MD, MS, FCCP, we asked him for a few thoughts about his upcoming presidential year. He kindly offered these responses:
What would be one of the many things you would like to accomplish as President of CHEST?
We plan to increase the engagement of our membership, and, in do so, allow for more opportunities to serve in leadership roles, educate as faculty, or to participate in more of the wide array of educational opportunities within CHEST – whether the member is a long-tenured physician, a trainee, an earlier career researcher or educator, or a colleague in the care team, such as a respiratory therapist, advanced practice provider, or a pharmacist. CHEST has been and will continue to be a leader in delivery of education, and will further advance opportunities to present breaking research. Ultimately, the reason we are in medicine is to improve the care that we deliver to our patients, so it is incumbent upon us to keep the mission aimed toward “patient-centric” goals.
What do you consider to be the greatest strength of CHEST, and how will you build upon this during your Presidency?
Our greatest strength is our members, who bring a diversity of experience, expertise, and passion for what they do at the forefront. Together, with our incredibly talented and dedicated support staff at CHEST, as well as our industry and publishing partners, our organization is poised to bring medical education in pulmonary, critical care, and sleep medicine globally to the next level. The CHEST Foundation has stimulated important opportunities for research, increased the ability for younger members to attend meetings and actively engage in CHEST activities, and provided valuable information to patients in a language they can understand. Thanks to advances in technology, there are improved platforms for communicating with our membership and for delivering education in novel and more effective ways than ever before. We plan to double down on our strategic focus of utilizing innovation and new technologies to lead trends in education, influence health-care improvements for our patients and their families, and to deliver the latest in medical education to clinicians and investigators worldwide.
What are some challenges facing CHEST, and how will you address these challenges?
Many of our members are facing challenges in their practices – both domestically and internationally. Industry and employer-based sponsorship to attend meetings has declined, travel remains expensive, and time away from the practice has become more and more difficult for a variety of reasons. Our members are being challenged with greater regulatory and administrative burdens and are bombarded with the demands of work overload. In addition to working with other organizations to identify workplace burnout and, more importantly, to offer better solutions, we are focused on leveraging a variety of new technologies to bring our CHEST brand of quality education to all of our members, regardless of location, and to do so in a way that best suits individual needs. The traditional model of attending a large meeting comprised solely of didactic presentations is, frankly, becoming outdated. CHEST will continue to “tip the apple cart” of worn out educational delivery methods and look toward innovating courses that are more accessible, more effective and relevant, more affordable, and more fun.
And finally, what is your charge to the members and new Fellows of CHEST?
We have each been blessed with the opportunity to serve patients and their families in their times of need. Let’s not forget that privilege as we deliver care each and every day. The word “doctor” comes from an agentive noun of the Latin verb docēre (“to teach”). Regardless of where you practice, what your role is in the health-care paradigm, or whether your contribution is directly with patients or indirectly through research, education, or administration, we are all teachers in various ways to various people. That’s why the American College of Chest Physicians (CHEST) needs to listen to your needs, cultivate your collective wisdom, and continue to be the leading organization within our specialties for delivering medical education and, ultimately, for providing outstanding care and compassion to our patients.
As we greet our new CHEST President, Clayton T. Cowl, MD, MS, FCCP, we asked him for a few thoughts about his upcoming presidential year. He kindly offered these responses:
What would be one of the many things you would like to accomplish as President of CHEST?
We plan to increase the engagement of our membership, and, in do so, allow for more opportunities to serve in leadership roles, educate as faculty, or to participate in more of the wide array of educational opportunities within CHEST – whether the member is a long-tenured physician, a trainee, an earlier career researcher or educator, or a colleague in the care team, such as a respiratory therapist, advanced practice provider, or a pharmacist. CHEST has been and will continue to be a leader in delivery of education, and will further advance opportunities to present breaking research. Ultimately, the reason we are in medicine is to improve the care that we deliver to our patients, so it is incumbent upon us to keep the mission aimed toward “patient-centric” goals.
What do you consider to be the greatest strength of CHEST, and how will you build upon this during your Presidency?
Our greatest strength is our members, who bring a diversity of experience, expertise, and passion for what they do at the forefront. Together, with our incredibly talented and dedicated support staff at CHEST, as well as our industry and publishing partners, our organization is poised to bring medical education in pulmonary, critical care, and sleep medicine globally to the next level. The CHEST Foundation has stimulated important opportunities for research, increased the ability for younger members to attend meetings and actively engage in CHEST activities, and provided valuable information to patients in a language they can understand. Thanks to advances in technology, there are improved platforms for communicating with our membership and for delivering education in novel and more effective ways than ever before. We plan to double down on our strategic focus of utilizing innovation and new technologies to lead trends in education, influence health-care improvements for our patients and their families, and to deliver the latest in medical education to clinicians and investigators worldwide.
What are some challenges facing CHEST, and how will you address these challenges?
Many of our members are facing challenges in their practices – both domestically and internationally. Industry and employer-based sponsorship to attend meetings has declined, travel remains expensive, and time away from the practice has become more and more difficult for a variety of reasons. Our members are being challenged with greater regulatory and administrative burdens and are bombarded with the demands of work overload. In addition to working with other organizations to identify workplace burnout and, more importantly, to offer better solutions, we are focused on leveraging a variety of new technologies to bring our CHEST brand of quality education to all of our members, regardless of location, and to do so in a way that best suits individual needs. The traditional model of attending a large meeting comprised solely of didactic presentations is, frankly, becoming outdated. CHEST will continue to “tip the apple cart” of worn out educational delivery methods and look toward innovating courses that are more accessible, more effective and relevant, more affordable, and more fun.
And finally, what is your charge to the members and new Fellows of CHEST?
We have each been blessed with the opportunity to serve patients and their families in their times of need. Let’s not forget that privilege as we deliver care each and every day. The word “doctor” comes from an agentive noun of the Latin verb docēre (“to teach”). Regardless of where you practice, what your role is in the health-care paradigm, or whether your contribution is directly with patients or indirectly through research, education, or administration, we are all teachers in various ways to various people. That’s why the American College of Chest Physicians (CHEST) needs to listen to your needs, cultivate your collective wisdom, and continue to be the leading organization within our specialties for delivering medical education and, ultimately, for providing outstanding care and compassion to our patients.
CHEST Foundation – designated as a Combined Federal Campaign-approved charity
The CHEST Foundation was recently designated as a Combined Federal Campaign-approved charity! The federal campaign started on September 10 and runs through January 11, 2019. If you are a federal employee organizing your workplace giving, you can easily choose the CHEST Foundation as your designated charity! Simply list our CFC number when designating your selected charity! CFC Number: 24565
To set up your CFC account, follow these easy steps outlined below:
1. Visit https://cfcgiving.opm.gov/welcome
2. From the welcome page, select “sign up now,” and fill out the required information if you do not have an account. If you do have an account, simply log in using the email address tied to your CFC account and your password, and skip to step 6.
3. After your account is set up, the CFC will send you an email to the address you provided along with a verification pin number. Select the “CLICK HERE to enter your PIN” option from the verification email, and enter the provided pin on the page provided by the link.
4. On the next page, you will create your security questions to log back into your account, should you lose your password. Select “Save Changes” at the bottom of the page when you are ready to move on.
5. Next, you’ll be asked to fill out some personal information about yourself as a donor, such as your full name, and which department of the federal government you work for. Choose “Save Changes” at the bottom of the page when you are done.
6. Upon completing the profile page (or logging into your account), you will be directed to the welcome page. Select the “Pledge Now” button, located in the center of the page.
7. The next page will ask you questions about the charity you would like to support. Enter the CHEST Foundation’s CFC number: 24565, and click “Search for Charities” to be directed to the next page.
8. Select the “add” button next to the CHEST Foundation’s listing. Then click the “checkout” button that appears in the pop-up window.
9. Fill out the requested information regarding your pledge amount, your pledge frequency, and your annual pledge amount, then select the “Continue with your pledge” option at the bottom of the page.
10. On this final page, you can review your pledge amount and review a brief attestation agreement. After reviewing, check the “I confirm” checkbox, then click “submit pledge.”
That’s it!
Thank you for supporting the CHEST Foundation’s mission-based programming supporting patient education materials, clinical research grants, and community service initiatives.
The CHEST Foundation was recently designated as a Combined Federal Campaign-approved charity! The federal campaign started on September 10 and runs through January 11, 2019. If you are a federal employee organizing your workplace giving, you can easily choose the CHEST Foundation as your designated charity! Simply list our CFC number when designating your selected charity! CFC Number: 24565
To set up your CFC account, follow these easy steps outlined below:
1. Visit https://cfcgiving.opm.gov/welcome
2. From the welcome page, select “sign up now,” and fill out the required information if you do not have an account. If you do have an account, simply log in using the email address tied to your CFC account and your password, and skip to step 6.
3. After your account is set up, the CFC will send you an email to the address you provided along with a verification pin number. Select the “CLICK HERE to enter your PIN” option from the verification email, and enter the provided pin on the page provided by the link.
4. On the next page, you will create your security questions to log back into your account, should you lose your password. Select “Save Changes” at the bottom of the page when you are ready to move on.
5. Next, you’ll be asked to fill out some personal information about yourself as a donor, such as your full name, and which department of the federal government you work for. Choose “Save Changes” at the bottom of the page when you are done.
6. Upon completing the profile page (or logging into your account), you will be directed to the welcome page. Select the “Pledge Now” button, located in the center of the page.
7. The next page will ask you questions about the charity you would like to support. Enter the CHEST Foundation’s CFC number: 24565, and click “Search for Charities” to be directed to the next page.
8. Select the “add” button next to the CHEST Foundation’s listing. Then click the “checkout” button that appears in the pop-up window.
9. Fill out the requested information regarding your pledge amount, your pledge frequency, and your annual pledge amount, then select the “Continue with your pledge” option at the bottom of the page.
10. On this final page, you can review your pledge amount and review a brief attestation agreement. After reviewing, check the “I confirm” checkbox, then click “submit pledge.”
That’s it!
Thank you for supporting the CHEST Foundation’s mission-based programming supporting patient education materials, clinical research grants, and community service initiatives.
The CHEST Foundation was recently designated as a Combined Federal Campaign-approved charity! The federal campaign started on September 10 and runs through January 11, 2019. If you are a federal employee organizing your workplace giving, you can easily choose the CHEST Foundation as your designated charity! Simply list our CFC number when designating your selected charity! CFC Number: 24565
To set up your CFC account, follow these easy steps outlined below:
1. Visit https://cfcgiving.opm.gov/welcome
2. From the welcome page, select “sign up now,” and fill out the required information if you do not have an account. If you do have an account, simply log in using the email address tied to your CFC account and your password, and skip to step 6.
3. After your account is set up, the CFC will send you an email to the address you provided along with a verification pin number. Select the “CLICK HERE to enter your PIN” option from the verification email, and enter the provided pin on the page provided by the link.
4. On the next page, you will create your security questions to log back into your account, should you lose your password. Select “Save Changes” at the bottom of the page when you are ready to move on.
5. Next, you’ll be asked to fill out some personal information about yourself as a donor, such as your full name, and which department of the federal government you work for. Choose “Save Changes” at the bottom of the page when you are done.
6. Upon completing the profile page (or logging into your account), you will be directed to the welcome page. Select the “Pledge Now” button, located in the center of the page.
7. The next page will ask you questions about the charity you would like to support. Enter the CHEST Foundation’s CFC number: 24565, and click “Search for Charities” to be directed to the next page.
8. Select the “add” button next to the CHEST Foundation’s listing. Then click the “checkout” button that appears in the pop-up window.
9. Fill out the requested information regarding your pledge amount, your pledge frequency, and your annual pledge amount, then select the “Continue with your pledge” option at the bottom of the page.
10. On this final page, you can review your pledge amount and review a brief attestation agreement. After reviewing, check the “I confirm” checkbox, then click “submit pledge.”
That’s it!
Thank you for supporting the CHEST Foundation’s mission-based programming supporting patient education materials, clinical research grants, and community service initiatives.
On-site coverage of CHEST 2018
CHEST Physician reporting staff will provide on-site coverage of CHEST 2018, the annual meeting of the American College of Chest Physicians, held in San Antonio, Tex., Oct. 6 through Oct. 10. They are planning to report on a wide variety of sessions covering the latest research on treating COPD, sleep medicine, pulmonary hypertension, asthma, and other pulmonary disease. Panels, plenaries, original research presentations, and late-breaking studies will all be covered in depth. Stories will be posted daily during the meeting on the CHEST Physician website. They will also be talking to presenters and discussants about their work, so be sure to watch for video interviews, which also will be published daily.
Among the sessions on the coverage calendar are the following:
The Impact of Obesity on Pulmonary Disorders. Sunday, Oct. 7, 7:30 a.m. to 8:30 a.m., Convention Center 207B
GAMES: Games Augmenting Medical Education. Sunday, Oct. 7, 10:45 a.m. to 11:45 a.m., Convention Center 207B
Current Trends and Controversies in the Practice of Sleep Medicine. Monday, Oct. 8, 7:30 a.m. to 8:30 a.m., Convention Center 214A
Futility? Responding to Nonbeneficial Treatment Requests. Monday, Oct. 8, 11:00 a.m. to 12:00 p.m., Convention Center 212A
Update on Diagnosis and Management of Diffuse Cystic Lung Disease. Tuesday, Oct. 9, 7:30 a.m. to 8:30 a.m., Convention Center 214A
Lung Cancer Screening: News Questions and New Answers. Tuesday, Oct. 9, 8:45 a.m. to 9:45 a.m., Convention Center 207A
Check here on the CHEST Physician website for the latest news from CHEST 2018!
CHEST Physician reporting staff will provide on-site coverage of CHEST 2018, the annual meeting of the American College of Chest Physicians, held in San Antonio, Tex., Oct. 6 through Oct. 10. They are planning to report on a wide variety of sessions covering the latest research on treating COPD, sleep medicine, pulmonary hypertension, asthma, and other pulmonary disease. Panels, plenaries, original research presentations, and late-breaking studies will all be covered in depth. Stories will be posted daily during the meeting on the CHEST Physician website. They will also be talking to presenters and discussants about their work, so be sure to watch for video interviews, which also will be published daily.
Among the sessions on the coverage calendar are the following:
The Impact of Obesity on Pulmonary Disorders. Sunday, Oct. 7, 7:30 a.m. to 8:30 a.m., Convention Center 207B
GAMES: Games Augmenting Medical Education. Sunday, Oct. 7, 10:45 a.m. to 11:45 a.m., Convention Center 207B
Current Trends and Controversies in the Practice of Sleep Medicine. Monday, Oct. 8, 7:30 a.m. to 8:30 a.m., Convention Center 214A
Futility? Responding to Nonbeneficial Treatment Requests. Monday, Oct. 8, 11:00 a.m. to 12:00 p.m., Convention Center 212A
Update on Diagnosis and Management of Diffuse Cystic Lung Disease. Tuesday, Oct. 9, 7:30 a.m. to 8:30 a.m., Convention Center 214A
Lung Cancer Screening: News Questions and New Answers. Tuesday, Oct. 9, 8:45 a.m. to 9:45 a.m., Convention Center 207A
Check here on the CHEST Physician website for the latest news from CHEST 2018!
CHEST Physician reporting staff will provide on-site coverage of CHEST 2018, the annual meeting of the American College of Chest Physicians, held in San Antonio, Tex., Oct. 6 through Oct. 10. They are planning to report on a wide variety of sessions covering the latest research on treating COPD, sleep medicine, pulmonary hypertension, asthma, and other pulmonary disease. Panels, plenaries, original research presentations, and late-breaking studies will all be covered in depth. Stories will be posted daily during the meeting on the CHEST Physician website. They will also be talking to presenters and discussants about their work, so be sure to watch for video interviews, which also will be published daily.
Among the sessions on the coverage calendar are the following:
The Impact of Obesity on Pulmonary Disorders. Sunday, Oct. 7, 7:30 a.m. to 8:30 a.m., Convention Center 207B
GAMES: Games Augmenting Medical Education. Sunday, Oct. 7, 10:45 a.m. to 11:45 a.m., Convention Center 207B
Current Trends and Controversies in the Practice of Sleep Medicine. Monday, Oct. 8, 7:30 a.m. to 8:30 a.m., Convention Center 214A
Futility? Responding to Nonbeneficial Treatment Requests. Monday, Oct. 8, 11:00 a.m. to 12:00 p.m., Convention Center 212A
Update on Diagnosis and Management of Diffuse Cystic Lung Disease. Tuesday, Oct. 9, 7:30 a.m. to 8:30 a.m., Convention Center 214A
Lung Cancer Screening: News Questions and New Answers. Tuesday, Oct. 9, 8:45 a.m. to 9:45 a.m., Convention Center 207A
Check here on the CHEST Physician website for the latest news from CHEST 2018!
AGA Research Foundation researcher of the month: David L. Boone, PhD
AGA Research Foundation pilot awards are an invaluable tool for investigators – they provide seed funding to explore promising new lines of research and generate preliminary data for larger grants. So, when David L. Boone, PhD, received the 2017 AGA-Pfizer Young Investigator Pilot Research Award in Inflammatory Bowel Disease from the AGA Research Foundation, he was able to double-down on a very targeted project studying innate immunity in IBD. Based on his recent accomplishments – both in and out of the lab – we’re excited for you to get to know Dr. Boone, associate professor of microbiology and immunology at Indiana University School of Medicine-South Bend, and our AGA Research Foundation researcher of the month.
Bench to bedside: working toward new treatment options in IBD
The Boone lab AGA-funded project is specifically focused on JAK inhibitors, which are becoming a more popular treatment option for patients with IBD, especially for those patients who don’t respond to anti-TNF therapy. Dr. Boone is committed to enhancing our understanding of how these JAK inhibitors work at a cellular level. If we can understand this, Dr. Boone is optimistic it will lead to new approaches for treating inflammation in IBD.
With his AGA Research Foundation grant, Dr. Boone and his lab characterized a new robust mouse model of colitis that is entirely driven by innate immune mechanisms. With this model, his team is investigating the cellular and molecular mechanisms that drive innate immune-mediated inflammation in the intestine, which will provide important insights for future IBD drug development. You can read the specifics of Dr. Boone’s research in his recently published work in Mucosal Immunology.
Pilot award provides a stepping stone
Dr. Boone’s AGA Research Foundation pilot grant has paved the way for future success. Using the data from his AGA-funded project, as well as the constructive feedback he received from the AGA awards panel, Dr. Boone went on to successfully obtain new funding in the form of a Pfizer ASPIRE research grant. This work is building the foundation for Dr. Boone’s next big grant venture: an NIH R01 grant.
Two postdocs, a graduate student, a technician, and a dog named Boone
Dr. Boone shared with us that the best outcome from his AGA grant was that the additional funding made it possible to grow his lab by a postdoctoral researcher and lab technician. One of Dr. Boone’s great passions is training the next generation of scientists, both in the lab and through his role as a microbiology and immunology professor for first-year medical students at Indiana University Medical School.
Beyond the lab – a commitment to IBD patients
Dr. Boone wanted to do more to support patients with IBD. He had heard of Camp Oasis – the Crohn’s & Colitis Foundation regional camp for patients with IBD – and knew of physicians who provided medical services at the camp. After looking into making a donation to Camp Oasis Michigan, Dr. Boone learned that what the camp really needed was male counselors. So, despite being “older than an average camp counselor,” Dr. Boone packed his bags for Michigan. Participating in Camp Oasis the last 2 years has been a great joy for Dr. Boone and provides added inspiration and motivation for his work in the lab.
The AGA Research Foundation is proud to fund researchers who are committed to improving the lives of patients – both in and out of the lab. You can help keep great researchers in GI by making a gift to the AGA Research Foundation, www.gastro.org/foundation.
AGA Research Foundation pilot awards are an invaluable tool for investigators – they provide seed funding to explore promising new lines of research and generate preliminary data for larger grants. So, when David L. Boone, PhD, received the 2017 AGA-Pfizer Young Investigator Pilot Research Award in Inflammatory Bowel Disease from the AGA Research Foundation, he was able to double-down on a very targeted project studying innate immunity in IBD. Based on his recent accomplishments – both in and out of the lab – we’re excited for you to get to know Dr. Boone, associate professor of microbiology and immunology at Indiana University School of Medicine-South Bend, and our AGA Research Foundation researcher of the month.
Bench to bedside: working toward new treatment options in IBD
The Boone lab AGA-funded project is specifically focused on JAK inhibitors, which are becoming a more popular treatment option for patients with IBD, especially for those patients who don’t respond to anti-TNF therapy. Dr. Boone is committed to enhancing our understanding of how these JAK inhibitors work at a cellular level. If we can understand this, Dr. Boone is optimistic it will lead to new approaches for treating inflammation in IBD.
With his AGA Research Foundation grant, Dr. Boone and his lab characterized a new robust mouse model of colitis that is entirely driven by innate immune mechanisms. With this model, his team is investigating the cellular and molecular mechanisms that drive innate immune-mediated inflammation in the intestine, which will provide important insights for future IBD drug development. You can read the specifics of Dr. Boone’s research in his recently published work in Mucosal Immunology.
Pilot award provides a stepping stone
Dr. Boone’s AGA Research Foundation pilot grant has paved the way for future success. Using the data from his AGA-funded project, as well as the constructive feedback he received from the AGA awards panel, Dr. Boone went on to successfully obtain new funding in the form of a Pfizer ASPIRE research grant. This work is building the foundation for Dr. Boone’s next big grant venture: an NIH R01 grant.
Two postdocs, a graduate student, a technician, and a dog named Boone
Dr. Boone shared with us that the best outcome from his AGA grant was that the additional funding made it possible to grow his lab by a postdoctoral researcher and lab technician. One of Dr. Boone’s great passions is training the next generation of scientists, both in the lab and through his role as a microbiology and immunology professor for first-year medical students at Indiana University Medical School.
Beyond the lab – a commitment to IBD patients
Dr. Boone wanted to do more to support patients with IBD. He had heard of Camp Oasis – the Crohn’s & Colitis Foundation regional camp for patients with IBD – and knew of physicians who provided medical services at the camp. After looking into making a donation to Camp Oasis Michigan, Dr. Boone learned that what the camp really needed was male counselors. So, despite being “older than an average camp counselor,” Dr. Boone packed his bags for Michigan. Participating in Camp Oasis the last 2 years has been a great joy for Dr. Boone and provides added inspiration and motivation for his work in the lab.
The AGA Research Foundation is proud to fund researchers who are committed to improving the lives of patients – both in and out of the lab. You can help keep great researchers in GI by making a gift to the AGA Research Foundation, www.gastro.org/foundation.
AGA Research Foundation pilot awards are an invaluable tool for investigators – they provide seed funding to explore promising new lines of research and generate preliminary data for larger grants. So, when David L. Boone, PhD, received the 2017 AGA-Pfizer Young Investigator Pilot Research Award in Inflammatory Bowel Disease from the AGA Research Foundation, he was able to double-down on a very targeted project studying innate immunity in IBD. Based on his recent accomplishments – both in and out of the lab – we’re excited for you to get to know Dr. Boone, associate professor of microbiology and immunology at Indiana University School of Medicine-South Bend, and our AGA Research Foundation researcher of the month.
Bench to bedside: working toward new treatment options in IBD
The Boone lab AGA-funded project is specifically focused on JAK inhibitors, which are becoming a more popular treatment option for patients with IBD, especially for those patients who don’t respond to anti-TNF therapy. Dr. Boone is committed to enhancing our understanding of how these JAK inhibitors work at a cellular level. If we can understand this, Dr. Boone is optimistic it will lead to new approaches for treating inflammation in IBD.
With his AGA Research Foundation grant, Dr. Boone and his lab characterized a new robust mouse model of colitis that is entirely driven by innate immune mechanisms. With this model, his team is investigating the cellular and molecular mechanisms that drive innate immune-mediated inflammation in the intestine, which will provide important insights for future IBD drug development. You can read the specifics of Dr. Boone’s research in his recently published work in Mucosal Immunology.
Pilot award provides a stepping stone
Dr. Boone’s AGA Research Foundation pilot grant has paved the way for future success. Using the data from his AGA-funded project, as well as the constructive feedback he received from the AGA awards panel, Dr. Boone went on to successfully obtain new funding in the form of a Pfizer ASPIRE research grant. This work is building the foundation for Dr. Boone’s next big grant venture: an NIH R01 grant.
Two postdocs, a graduate student, a technician, and a dog named Boone
Dr. Boone shared with us that the best outcome from his AGA grant was that the additional funding made it possible to grow his lab by a postdoctoral researcher and lab technician. One of Dr. Boone’s great passions is training the next generation of scientists, both in the lab and through his role as a microbiology and immunology professor for first-year medical students at Indiana University Medical School.
Beyond the lab – a commitment to IBD patients
Dr. Boone wanted to do more to support patients with IBD. He had heard of Camp Oasis – the Crohn’s & Colitis Foundation regional camp for patients with IBD – and knew of physicians who provided medical services at the camp. After looking into making a donation to Camp Oasis Michigan, Dr. Boone learned that what the camp really needed was male counselors. So, despite being “older than an average camp counselor,” Dr. Boone packed his bags for Michigan. Participating in Camp Oasis the last 2 years has been a great joy for Dr. Boone and provides added inspiration and motivation for his work in the lab.
The AGA Research Foundation is proud to fund researchers who are committed to improving the lives of patients – both in and out of the lab. You can help keep great researchers in GI by making a gift to the AGA Research Foundation, www.gastro.org/foundation.
Mayo Clinic announces new president and CEO: Gianrico Farrugia, MD
The Mayo Clinic Board of Trustees has announced that Gianrico Farrugia, MD, vice president and CEO of Mayo Clinic Florida, will take over as president and CEO of Mayo Clinic at the end of the year. AGA congratulates Dr. Farrugia on this accomplishment.
Here’s three reasons why AGA is excited by this news:
1. Dr. Farrugia is an accomplished GI investigator. Dr. Farrugia runs an NIH-funded translational laboratory focused on disorders of GI motility. The aim of Dr. Farrugia’s work is to understand at a cellular, subcellular and molecular level how the normal functions of the GI tract determine the defects that result in diseases such as diabetic gastroparesis, slow transit constipation, and irritable bowel syndrome (IBS), which will ultimately lead to new strategies to treat these diseases by developing targeted disease-modifying agents.
2. Dr. Farrugia is an alumnus of the AGA Research Foundation Research Scholar Award program. Dr. Farrugia received his Research Scholar Award in 1994 for his project titled “Jejunal Smooth Muscle Ion Channel Regulation in Health and Disease.”
3. Dr. Farrugia has given back to AGA both with his time – serving on the AGA Nominating Committee, AGA Institute Council, and Cellular and Molecular Gastroenterology and Hepatology editorial board – and by contributing, with his wife Geraldine Farrugia, to the AGA Research Foundation at the highest level as an AGA Legacy Society member.
Join AGA members in congratulating Dr. Farrugia in the AGA Community, community.gastro.org.
The Mayo Clinic Board of Trustees has announced that Gianrico Farrugia, MD, vice president and CEO of Mayo Clinic Florida, will take over as president and CEO of Mayo Clinic at the end of the year. AGA congratulates Dr. Farrugia on this accomplishment.
Here’s three reasons why AGA is excited by this news:
1. Dr. Farrugia is an accomplished GI investigator. Dr. Farrugia runs an NIH-funded translational laboratory focused on disorders of GI motility. The aim of Dr. Farrugia’s work is to understand at a cellular, subcellular and molecular level how the normal functions of the GI tract determine the defects that result in diseases such as diabetic gastroparesis, slow transit constipation, and irritable bowel syndrome (IBS), which will ultimately lead to new strategies to treat these diseases by developing targeted disease-modifying agents.
2. Dr. Farrugia is an alumnus of the AGA Research Foundation Research Scholar Award program. Dr. Farrugia received his Research Scholar Award in 1994 for his project titled “Jejunal Smooth Muscle Ion Channel Regulation in Health and Disease.”
3. Dr. Farrugia has given back to AGA both with his time – serving on the AGA Nominating Committee, AGA Institute Council, and Cellular and Molecular Gastroenterology and Hepatology editorial board – and by contributing, with his wife Geraldine Farrugia, to the AGA Research Foundation at the highest level as an AGA Legacy Society member.
Join AGA members in congratulating Dr. Farrugia in the AGA Community, community.gastro.org.
The Mayo Clinic Board of Trustees has announced that Gianrico Farrugia, MD, vice president and CEO of Mayo Clinic Florida, will take over as president and CEO of Mayo Clinic at the end of the year. AGA congratulates Dr. Farrugia on this accomplishment.
Here’s three reasons why AGA is excited by this news:
1. Dr. Farrugia is an accomplished GI investigator. Dr. Farrugia runs an NIH-funded translational laboratory focused on disorders of GI motility. The aim of Dr. Farrugia’s work is to understand at a cellular, subcellular and molecular level how the normal functions of the GI tract determine the defects that result in diseases such as diabetic gastroparesis, slow transit constipation, and irritable bowel syndrome (IBS), which will ultimately lead to new strategies to treat these diseases by developing targeted disease-modifying agents.
2. Dr. Farrugia is an alumnus of the AGA Research Foundation Research Scholar Award program. Dr. Farrugia received his Research Scholar Award in 1994 for his project titled “Jejunal Smooth Muscle Ion Channel Regulation in Health and Disease.”
3. Dr. Farrugia has given back to AGA both with his time – serving on the AGA Nominating Committee, AGA Institute Council, and Cellular and Molecular Gastroenterology and Hepatology editorial board – and by contributing, with his wife Geraldine Farrugia, to the AGA Research Foundation at the highest level as an AGA Legacy Society member.
Join AGA members in congratulating Dr. Farrugia in the AGA Community, community.gastro.org.
Rising microbiome investigator: Ting-Chin David Shen, MD, PhD
We spoke with Dr. Shen, instructor of medicine at the University of Pennsylvania and the recipient of the AGA Research Foundation’s 2016 Microbiome Junior Investigator Award, to learn about his passion for gut microbiome research.
How would you sum up your research in one sentence?
My research examines the metabolic interactions between the gut microbiota and the mammalian host, with a particular emphasis on amino acid metabolism and nitrogen flux via the bacterial enzyme urease.
What impact do you hope your research will have on patients?
My hope is that by better understanding the biological mechanisms by which the gut microbiota impacts host metabolism, we can modulate its effects to treat a variety of conditions and diseases including hepatic encephalopathy, inborn errors of metabolism, obesity, malnutrition, etc.
What inspired you to focus your research career on the gut microbiome?
My clinical experience as a gastroenterologist inspired my interest in metabolic and nutritional research. When I learned of the impact that the gut microbiota has on host metabolism, it created an entirely different perspective for me in terms of thinking about how to treat metabolic and nutritional disorders. There are tremendous opportunities in modifying our gut microbiota in concert with dietary interventions in order to modulate our metabolism.
What recent publication from your lab best represents your work, if anyone wants to learn more?
The following work examined how the use of a defined bacterial consortium without urease activity can reduce colonic ammonia level upon inoculation into the gut and ameliorate morbidity and mortality in a murine model of liver disease: Shen T.D., Albenberg L.A., Bittinger K., et al, Engineering the gut microbiota to treat hyperammonemia. J Clin Invest. 2015 Jul 1;125(7):2841-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563680/.
We spoke with Dr. Shen, instructor of medicine at the University of Pennsylvania and the recipient of the AGA Research Foundation’s 2016 Microbiome Junior Investigator Award, to learn about his passion for gut microbiome research.
How would you sum up your research in one sentence?
My research examines the metabolic interactions between the gut microbiota and the mammalian host, with a particular emphasis on amino acid metabolism and nitrogen flux via the bacterial enzyme urease.
What impact do you hope your research will have on patients?
My hope is that by better understanding the biological mechanisms by which the gut microbiota impacts host metabolism, we can modulate its effects to treat a variety of conditions and diseases including hepatic encephalopathy, inborn errors of metabolism, obesity, malnutrition, etc.
What inspired you to focus your research career on the gut microbiome?
My clinical experience as a gastroenterologist inspired my interest in metabolic and nutritional research. When I learned of the impact that the gut microbiota has on host metabolism, it created an entirely different perspective for me in terms of thinking about how to treat metabolic and nutritional disorders. There are tremendous opportunities in modifying our gut microbiota in concert with dietary interventions in order to modulate our metabolism.
What recent publication from your lab best represents your work, if anyone wants to learn more?
The following work examined how the use of a defined bacterial consortium without urease activity can reduce colonic ammonia level upon inoculation into the gut and ameliorate morbidity and mortality in a murine model of liver disease: Shen T.D., Albenberg L.A., Bittinger K., et al, Engineering the gut microbiota to treat hyperammonemia. J Clin Invest. 2015 Jul 1;125(7):2841-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563680/.
We spoke with Dr. Shen, instructor of medicine at the University of Pennsylvania and the recipient of the AGA Research Foundation’s 2016 Microbiome Junior Investigator Award, to learn about his passion for gut microbiome research.
How would you sum up your research in one sentence?
My research examines the metabolic interactions between the gut microbiota and the mammalian host, with a particular emphasis on amino acid metabolism and nitrogen flux via the bacterial enzyme urease.
What impact do you hope your research will have on patients?
My hope is that by better understanding the biological mechanisms by which the gut microbiota impacts host metabolism, we can modulate its effects to treat a variety of conditions and diseases including hepatic encephalopathy, inborn errors of metabolism, obesity, malnutrition, etc.
What inspired you to focus your research career on the gut microbiome?
My clinical experience as a gastroenterologist inspired my interest in metabolic and nutritional research. When I learned of the impact that the gut microbiota has on host metabolism, it created an entirely different perspective for me in terms of thinking about how to treat metabolic and nutritional disorders. There are tremendous opportunities in modifying our gut microbiota in concert with dietary interventions in order to modulate our metabolism.
What recent publication from your lab best represents your work, if anyone wants to learn more?
The following work examined how the use of a defined bacterial consortium without urease activity can reduce colonic ammonia level upon inoculation into the gut and ameliorate morbidity and mortality in a murine model of liver disease: Shen T.D., Albenberg L.A., Bittinger K., et al, Engineering the gut microbiota to treat hyperammonemia. J Clin Invest. 2015 Jul 1;125(7):2841-50. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563680/.
AGA comments on HHS’ drug affordability blueprint
AGA’s new drug affordability principles were put into action in July when AGA Chair Sheila Crowe, MD, AGAF, provided comments on the Department of Health & Human Services (HHS) recent policy statement and Request for Information, “HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs” (Blueprint). Comments were limited to four areas of the Blueprint.
Medicare Part B to Part D drug transition
Over the past decade there has been interest in consolidating Part B and Part D drug coverage and payment. AGA urges physician-administered drugs and biologics to remain under Part B due to the complexities surrounding them.
Since Part D does not allow for supplemental coverage and has higher coinsurance, this action would achieve savings by shifting costs to Medicare beneficiaries. Moving them to Part D would also increase the risk of waste leading to unnecessary Medicare spending. AGA urges the administration to avoid policy solutions that achieve Medicare program savings at the expense of Medicare beneficiaries.
Indication-based payments
The Blueprint seems to imply that off-label uses of prescription drugs are inherently less valuable than on-label uses. If the administration moves towards value-based pricing, off-label indications should not automatically be valued less, or priced lower, than on-label indications. Specifically, AGA urges the administration to ensure all medically accepted indications are appropriately valued for a drug or biologic.
Medicare Part B Competitive Acquisition Program (CAP)
AGA does not oppose the idea of a new, voluntary CAP program as it would allow interested physicians and practices to provide Part B drug administration without the burden of high acquisition costs.
AGA strongly opposes a future Part B CAP that includes vendors or Medicare carriers conducting medical reviews or utilization management. Utilization management undermines shared decision-making between physicians and patients, increases physician burden, and often puts patients at risk by delaying access to necessary care.
Reduce patient out-of-pocket spending
As out-of-pocket costs continue to rise, AGA supports the administration’s plans to increase cost transparency in the Medicare program as it increases the efficiency of the shared decision-making process between patient and physician. Drug and biologic manufacturers, health plans, and pharmacy managers should work together to lower out-of-pocket expenses for Medicare beneficiaries and for all people with digestive diseases.
Although AGA shares the Blueprint’s goal of lowering the cost of prescription drugs, lowering out-of-pocket costs for patients, increasing competition and fostering innovation, we are concerned that the recent proposal by the Trump administration to allow Medicare Advantage (MA) plans to utilize step therapy would threaten the aforementioned goals. Step therapy is a utilization management tool used by insurers that requires patients to fail one or more medications before covering the original therapy that is prescribed by the physician. AGA is concerned that the recent announcement by the Trump administration would not provide patients with the necessary protections, would increase the regulatory burden that physicians already face with step therapy and prior authorization, and could hinder innovation by preferring the lowest cost medication which may not necessarily be the most effective. AGA will continue to push for necessary patient protections to ensure that patients have the ability to appeal step therapy protocols when appropriate and are able to receive the medication that their physician thinks is the most effective to manage their condition.
AGA’s new drug affordability principles were put into action in July when AGA Chair Sheila Crowe, MD, AGAF, provided comments on the Department of Health & Human Services (HHS) recent policy statement and Request for Information, “HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs” (Blueprint). Comments were limited to four areas of the Blueprint.
Medicare Part B to Part D drug transition
Over the past decade there has been interest in consolidating Part B and Part D drug coverage and payment. AGA urges physician-administered drugs and biologics to remain under Part B due to the complexities surrounding them.
Since Part D does not allow for supplemental coverage and has higher coinsurance, this action would achieve savings by shifting costs to Medicare beneficiaries. Moving them to Part D would also increase the risk of waste leading to unnecessary Medicare spending. AGA urges the administration to avoid policy solutions that achieve Medicare program savings at the expense of Medicare beneficiaries.
Indication-based payments
The Blueprint seems to imply that off-label uses of prescription drugs are inherently less valuable than on-label uses. If the administration moves towards value-based pricing, off-label indications should not automatically be valued less, or priced lower, than on-label indications. Specifically, AGA urges the administration to ensure all medically accepted indications are appropriately valued for a drug or biologic.
Medicare Part B Competitive Acquisition Program (CAP)
AGA does not oppose the idea of a new, voluntary CAP program as it would allow interested physicians and practices to provide Part B drug administration without the burden of high acquisition costs.
AGA strongly opposes a future Part B CAP that includes vendors or Medicare carriers conducting medical reviews or utilization management. Utilization management undermines shared decision-making between physicians and patients, increases physician burden, and often puts patients at risk by delaying access to necessary care.
Reduce patient out-of-pocket spending
As out-of-pocket costs continue to rise, AGA supports the administration’s plans to increase cost transparency in the Medicare program as it increases the efficiency of the shared decision-making process between patient and physician. Drug and biologic manufacturers, health plans, and pharmacy managers should work together to lower out-of-pocket expenses for Medicare beneficiaries and for all people with digestive diseases.
Although AGA shares the Blueprint’s goal of lowering the cost of prescription drugs, lowering out-of-pocket costs for patients, increasing competition and fostering innovation, we are concerned that the recent proposal by the Trump administration to allow Medicare Advantage (MA) plans to utilize step therapy would threaten the aforementioned goals. Step therapy is a utilization management tool used by insurers that requires patients to fail one or more medications before covering the original therapy that is prescribed by the physician. AGA is concerned that the recent announcement by the Trump administration would not provide patients with the necessary protections, would increase the regulatory burden that physicians already face with step therapy and prior authorization, and could hinder innovation by preferring the lowest cost medication which may not necessarily be the most effective. AGA will continue to push for necessary patient protections to ensure that patients have the ability to appeal step therapy protocols when appropriate and are able to receive the medication that their physician thinks is the most effective to manage their condition.
AGA’s new drug affordability principles were put into action in July when AGA Chair Sheila Crowe, MD, AGAF, provided comments on the Department of Health & Human Services (HHS) recent policy statement and Request for Information, “HHS Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs” (Blueprint). Comments were limited to four areas of the Blueprint.
Medicare Part B to Part D drug transition
Over the past decade there has been interest in consolidating Part B and Part D drug coverage and payment. AGA urges physician-administered drugs and biologics to remain under Part B due to the complexities surrounding them.
Since Part D does not allow for supplemental coverage and has higher coinsurance, this action would achieve savings by shifting costs to Medicare beneficiaries. Moving them to Part D would also increase the risk of waste leading to unnecessary Medicare spending. AGA urges the administration to avoid policy solutions that achieve Medicare program savings at the expense of Medicare beneficiaries.
Indication-based payments
The Blueprint seems to imply that off-label uses of prescription drugs are inherently less valuable than on-label uses. If the administration moves towards value-based pricing, off-label indications should not automatically be valued less, or priced lower, than on-label indications. Specifically, AGA urges the administration to ensure all medically accepted indications are appropriately valued for a drug or biologic.
Medicare Part B Competitive Acquisition Program (CAP)
AGA does not oppose the idea of a new, voluntary CAP program as it would allow interested physicians and practices to provide Part B drug administration without the burden of high acquisition costs.
AGA strongly opposes a future Part B CAP that includes vendors or Medicare carriers conducting medical reviews or utilization management. Utilization management undermines shared decision-making between physicians and patients, increases physician burden, and often puts patients at risk by delaying access to necessary care.
Reduce patient out-of-pocket spending
As out-of-pocket costs continue to rise, AGA supports the administration’s plans to increase cost transparency in the Medicare program as it increases the efficiency of the shared decision-making process between patient and physician. Drug and biologic manufacturers, health plans, and pharmacy managers should work together to lower out-of-pocket expenses for Medicare beneficiaries and for all people with digestive diseases.
Although AGA shares the Blueprint’s goal of lowering the cost of prescription drugs, lowering out-of-pocket costs for patients, increasing competition and fostering innovation, we are concerned that the recent proposal by the Trump administration to allow Medicare Advantage (MA) plans to utilize step therapy would threaten the aforementioned goals. Step therapy is a utilization management tool used by insurers that requires patients to fail one or more medications before covering the original therapy that is prescribed by the physician. AGA is concerned that the recent announcement by the Trump administration would not provide patients with the necessary protections, would increase the regulatory burden that physicians already face with step therapy and prior authorization, and could hinder innovation by preferring the lowest cost medication which may not necessarily be the most effective. AGA will continue to push for necessary patient protections to ensure that patients have the ability to appeal step therapy protocols when appropriate and are able to receive the medication that their physician thinks is the most effective to manage their condition.
AGA Center for Gut Microbiome Research and Education scientific advisory board welcomes new members
Four leading experts in microbiome research have recently been appointed to the scientific advisory board of the AGA Center for Gut Microbiome Research and Education.
Robert A. Britton, PhD
Baylor College of Medicine, Houston, Texas
Dr. Britton studies the role of microbes in health and diseases, with a focus on identifying microbes with therapeutic properties for a variety of disorders.
Suzanne Devkota, PhD
Cedars-Sinai Medical Center, Los Angeles, California
Dr. Devkota investigates the role of diet in shaping the community of bacteria that live in our intestines (the “gut microbiome”).
Lita M. Proctor, PhD
National Human Genome Research Institute, Rockville, Maryland
Dr. Proctor is responsible for coordination of the Human Microbiome Project (HMP), an eight-year NIH Common Fund initiative to create a toolbox of resources for the emerging field of microbiome research.
Liping Zhao, PhD
Rutgers University, New Brunswick, New Jersey
Dr. Zhao studies the interactions between diet and gut microbiota in the onset and progression of chronic diseases such as obesity and diabetes.
AGA recognizes the outgoing members of the scientific advisory board who have made valuable contributions to the center’s work over their terms: Lee M. Kaplan, MD, PhD, AGAF, Zain Kassam, MD, MPH, and Ece Mutlu, MD, MBA, AGAF.
Four leading experts in microbiome research have recently been appointed to the scientific advisory board of the AGA Center for Gut Microbiome Research and Education.
Robert A. Britton, PhD
Baylor College of Medicine, Houston, Texas
Dr. Britton studies the role of microbes in health and diseases, with a focus on identifying microbes with therapeutic properties for a variety of disorders.
Suzanne Devkota, PhD
Cedars-Sinai Medical Center, Los Angeles, California
Dr. Devkota investigates the role of diet in shaping the community of bacteria that live in our intestines (the “gut microbiome”).
Lita M. Proctor, PhD
National Human Genome Research Institute, Rockville, Maryland
Dr. Proctor is responsible for coordination of the Human Microbiome Project (HMP), an eight-year NIH Common Fund initiative to create a toolbox of resources for the emerging field of microbiome research.
Liping Zhao, PhD
Rutgers University, New Brunswick, New Jersey
Dr. Zhao studies the interactions between diet and gut microbiota in the onset and progression of chronic diseases such as obesity and diabetes.
AGA recognizes the outgoing members of the scientific advisory board who have made valuable contributions to the center’s work over their terms: Lee M. Kaplan, MD, PhD, AGAF, Zain Kassam, MD, MPH, and Ece Mutlu, MD, MBA, AGAF.
Four leading experts in microbiome research have recently been appointed to the scientific advisory board of the AGA Center for Gut Microbiome Research and Education.
Robert A. Britton, PhD
Baylor College of Medicine, Houston, Texas
Dr. Britton studies the role of microbes in health and diseases, with a focus on identifying microbes with therapeutic properties for a variety of disorders.
Suzanne Devkota, PhD
Cedars-Sinai Medical Center, Los Angeles, California
Dr. Devkota investigates the role of diet in shaping the community of bacteria that live in our intestines (the “gut microbiome”).
Lita M. Proctor, PhD
National Human Genome Research Institute, Rockville, Maryland
Dr. Proctor is responsible for coordination of the Human Microbiome Project (HMP), an eight-year NIH Common Fund initiative to create a toolbox of resources for the emerging field of microbiome research.
Liping Zhao, PhD
Rutgers University, New Brunswick, New Jersey
Dr. Zhao studies the interactions between diet and gut microbiota in the onset and progression of chronic diseases such as obesity and diabetes.
AGA recognizes the outgoing members of the scientific advisory board who have made valuable contributions to the center’s work over their terms: Lee M. Kaplan, MD, PhD, AGAF, Zain Kassam, MD, MPH, and Ece Mutlu, MD, MBA, AGAF.