American College of Cardiology

Obama Signs Law Reauthorizing SCHIP

President Obama on Feb. 4 signed into law a $32.8 billion reauthorization and expansion of the Children’s Health Insurance Program. The Senate on Jan. 29 approved the bill, after the House approved a different version of the bill on Jan. 14. The reauthorization provides health care coverage for 7 million children in lower-income families and is partially funded through a tobacco tax, which the ACC supports. The law does not include as a funding mechanism a ban on physician self-referral to hospitals in which they have an ownership interest, as was included in the House version of the bill. The ACC did not support this provision. More coverage is available from the Wall Street Journal Health Blog.

In related news, President Obama also recently lifted restrictions put in place by former President Bush to limit enrollment for children in families in higher income brackets. Under the restrictions, the federal government would not approve any SCHIP expansion to children in families with incomes above 200 percent of the federal poverty level unless the state had a 95 percent enrollment rate for children in lower-income families. According to the AP/Washington Post, “many governors and Democratic lawmakers said [the restrictions] were nearly impossible to meet.”

Congressional Leaders Work on Recovery Act Compromise

House and Senate leaders are working on an agreement that reconciles the House and Senate-approved "American Recovery and Reinvestment Act." The Senate on Tuesday in a 61-37 vote approved a $838 billion economic stimulus package that includes funding for several health initiatives. The House last month passed a different version stimulus package worth $819 billion. The Senate bill includes $19 billion for health information technology (IT), while the House version contains $20 billion in funding. The Senate bill would provide incentives for EHR use beginning in 2011, with penalties for those not using EHRs by 2015. The House would begin to penalize in 2016. Both versions of the Recovery Act include $1.1 billion for comparative effectiveness research.

The Senate bill provides about $10 billion in funding for the National Institutes of Health for research, and facility and equipment upgrades, compared to the House’s $2 billion in funding. The Senate dropped funding for preventive health care services that was present in the House bill. The Senate bill also contains higher payments to hospitals that treat higher numbers of low-income, Medicaid and uninsured patients, which is not included in the House bill. The goal is to have the House and Senate approve a compromise package by the end of this week. More coverage is available from MedPage Today.

Now Available: ACC Guide to 2009 Coding and Payment Changes
Significant changes in cardiac device monitoring codes, as well as echocardiography codes, will mark 2009 as a sentinel year for cardiology coding and payment. The ACC has prepared an overview to help ease the transition to the new codes and better enable physicians and coders to prepare for and comply with the new coding structures. View the guide. Also, the document will appear as a special insert in the February issue of Cardiology.

FDA News Updates

The Food and Drug Administration (FDA) has granted approval to Biosense Webster’s NaviStar ThermoCool Catheter for treatment in patients with drug refractory recurrent symptomatic paroxysmal atrial fibrillation, to be used with compatible 3-D electroanatomic mapping systems. The system had previously been approved for atrial flutter and recurrent drug/device refractory sustained monomorphic ventricular tachycardia due to prior myocardial infarction. FDA also approved Biosense’s EZ Steer ThermoCool, which is a bi-directional version of the NaviStar catheter. More information is available from Cardiovascular Business magazine.

QUALITY

Medicare Beneficiaries: Health Care Third-Largest Household Expense

Health care accounts for 14.1 percent of an average Medicare beneficiaries household expenses, ranking behind transportation and housing in budget expenses, according to a recent study by the Kaiser Family Foundation. The study, based on 2006 data from the U.S. Bureau of Labor Statistics, found that health care accounted for 4.3 percent of household spending by individuals not covered by Medicare. Median out-of-pocket expenses for Medicare beneficiaries in the top quartile of spending was $7,800 per year – or 32.9 percent of household expenses -- on average for premium, prescription drugs, or medical services and supplies. More about the report is available on the Kaiser Family Foundation Web site.

Health IT Associated with Positive Outcomes, Study Finds

Texas hospitals that have some computerized portions of their information systems appear to have fewer complications, lower death rates and lower costs, according to a study in the Jan. 26 issue of Archives of Internal Medicine, Cardiovascular Business magazine reports. The study divided the hospitals’ clinical systems into four categories: medical records and notes, test results, order entry, and clinical decision support, and asked 41 hospitals to rate their automation in 2005 and 2006 in each of the areas. Increased automation of medical records and notes was associated with a 15 percent decline in the rate of in-hospital death for all medical conditions. Increased automation of test results, order entry and decision support was associated with lower costs for all admissions, according to the study. The report is available online.