April 4, 2005

REIMBURSEMENT

Five-Year Review of Cardiology Codes is Under Way
As part of a mandated review of CPT codes, the Centers for Medicare and Medicaid Services (CMS) will be surveying physicians in early May to determine actual work times for procedures. It is imperative that every ACC member who receives a survey respond immediately to ensure that cardiovascular services are appropriately valued. Survey results will be used to determine reimbursement for the next five years.

CMS Tests Payment Accuracy
CMS recently announced a three-year demonstration in California, Florida and New York that will evaluate methods of reducing inappropriate billing by Medicare providers. As part of the demonstration, CMS will work with recovery audit contractors to evaluate claims for overpayments or underpayments. The program will target claims that are often improperly coded, such as claims where Medicare is not the primary payer or for bundled services. Click here to read the CMS announcement.

MEDICAL LIABILITY REFORM

Missouri, Montana Strengthen Liability Laws
Missouri Gov. Matt Blunt signed legislation last week that creates a $350,000 limit on noneconomic damages in medical liability lawsuits. The new law, which goes into effect Aug. 28, requires lawsuits to be filed in the county where the alleged injury occurred and provides a stricter interpretation of joint and several liability. “Missourians deserve access to health care and businesses deserve the right to create jobs,” Blunt said. “This legislation will do both.” Click here to read the Governor’s statement.

Severe shortages of specialists in rural areas of Montana prompted Gov. Brian Schweitzer to sign four bills to ease the medical liability burden on physicians. The legislative package enforces stricter criteria for determining expert witnesses, protects physicians from being sued for medical errors made by another provider, prohibits a physician’s apology from being used in a medical liability claim and protects hospitals from being sued for the work of independent contractors. These laws will go into effect July 1, 2005. Visit www.protectpatientsnow.org to get a state-by-state analysis of the fight for medical liability reform.

South Carolina Awaits Action by Governor
South Carolina physicians are hoping that Gov. Mark Sanford signs a bill capping noneconomic damages at $350,000 in medical liability cases. The legislation would also create additional qualifications for expert witnesses. Sanford has been a strong supporter of liability reform and recently signed a law aimed at preventing frivolous lawsuits from ever reaching the courtroom (see related story).

Free Audioconference on HIPAA Security Rule
CMS will host a free teleconference on April 6 to help health care providers comply with the HIPAA Security Rule by the April 20 deadline. The Security Rule governs collection, storage and transmission of patients’ protected health information. The teleconference is from 1 – 2 p.m. ET, and interested members can find out more at www.sharpworkgroup.com.

Tobacco Control Bill Introduced
Congress recently introduced bipartisan legislation that would authorize the Food and Drug Administration (FDA) to closely monitor and regulate tobacco products. The Senate and House bills are identical to legislation introduced and supported by the ACC last year. The bill would not allow the FDA to ban cigarettes, but the agency could regulate tobacco products, reduce usage of the additive nicotine, curb advertising to children and mandate the use of bolder health warnings on tobacco packaging. The ACC continues to work with the Campaign for Tobacco Free Kids to support passage of this legislation. Click here to learn more.