Senate
Action on Medicare Legislation Expected This Week
The Senate Finance Committee has announced that it will hold
a markup of Medicare legislation this week. It is important
that ACC members contact their senators in support of action
to stop the 10 percent Medicare physician payment cut, ensure
a two-year payment update, protect medical imaging from further
cuts, and foster efforts to improve medical imaging appropriateness
and quality. ACC members can contact their senators through
the ACC Grassroots Hotline, 800-210-7193.
Discussions
On Public Reporting Legislation Continue
Discussions continue on the “Wired for Health Care Quality
Act of 2007” (S. 1693) and its section that would allow
the public reporting of physician-identified Medicare claims
data. The ACC and other physician specialty organizations
have met numerous times with staff for the legislation’s
sponsors, Sens. Edward Kennedy (D-MA), Mike Enzi (R-WY), Orrin
Hatch (R-UT) and Hillary Clinton (D-NY), to discuss the serious
problems with public reporting based on claims data and suggested
modifications to the legislation. In response, the Senate
staff has offered a few positive modifications—including
a requirement that reports not be released unless the data
is risk-adjusted and that physician consultants be given the
opportunity to review the reports and comment on the accuracy
of their data. However, many questions remain on the legislation
and ACC staff are following it closely.
New
York Lawmakers Considering Public Reporting Law
Acting on concerns about physician rankings, New York lawmakers
this week said that they would pass a law to force health
insurers that rank physicians to evaluate patient care first
and stop using costs as the sole measure. Legislative leaders
joined Attorney General Andrew Cuomo to announce the proposal.
Six health insurance companies have signed agreements with
Cuomo to adopt the doctor-ranking protocols, and four have
agreed to apply the principles nationwide.
QUALITY
Medtronic
Facing Probe Over Alleged Physician Payments According to the “Wall Street Journal,”
Medtronic Inc. "said in a Securities and Exchange Commission
(SEC) filing that the Senate Finance Committee has requested
information about ties between the medical-device industry
and practicing physicians," as well as "information
about" the company's "suspended distribution of
its Sprint Fidelis family of defibrillation leads." In
addition, the Justice Department is seeking any information
provided by Medtronic to the SEC “about payments made
to foreign doctors in possible violation of the U.S. Foreign
Corrupt Practices Act."
PAYER
Mandatory
Reporting of the National Provider Identifier on All Part
B Claims As of March 3, 2008, Medicare fee-for-service claims
must include a national provider identifier (NPI) in the primary
provider fields on the claim (i.e., the billing, pay-to provider,
and rendering provider fields). Failure to submit an NPI in
the primary provider fields will result in the claim being
rejected. The secondary provider fields (i.e., referring,
ordering and supervising) may continue to include only the
legacy number. The ACC urges physicians who already bill using
the NPI/legacy pair in the primary provider fields, to submit
a small number of claims containing only the NPI to their
contractor at this time. This test will help assure that claims
will be successfully processed when only the NPI is mandated.
