American College of Cardiology

	Bush Calls for Medical Liability Reforms
	Medical Liability Reform Bill Introduced in Senate
	FDA Advisory Committee Votes Against Omapatrilat, For Statin/Aspirin Combo
	Anthem Acquisition of Trigon Approved
	New NCCI Edits Added for Version 8.3
	Senate Approves Carmona as New Surgeon General
	FDA Approves OTC Device to Treat Hypertension
	Funding for Smoking Prevention Programs Victim of State Budgetary Woes

Bush Calls for Medical Liability Reforms
President Bush last week signaled his support for major medical liability reforms. The president's proposed framework includes a $250,000 cap on noneconomic damages in medical malpractice cases; national adoption of proven minimum standards aimed at making the medical liability system "more fair, predictable, and timely"; and the payment of judgments over time rather than in a single lump sum. President Bush's proposed framework largely reflects the reforms included in the "HEALTH Act of 2002," H.R. 4600/S. 2793, a medical liability reform bill supported by the ACC. The president's call for reforms were issued simultaneously with an HHS report on how the current liability system is affecting the delivery of health care. The president proposed the reforms during a July 25 speech at Highpoint University in Highpoint, N.C. The ACC met with Bush adminstration staff about medical liability several days before the speech, and ACC member Joseph LeBauer, MD, attended the event on the College's behalf.

Medical Liability Reform Bill Introduced in Senate
In related news, last week Sen. John Ensign, R-Nev., introduced a medical liability reform bill in the Senate. The bill, S. 2793, is identical to the House bill, H.R 4600. Also, as early as this Tuesday, the Senate could vote on a medical liability reform amendment to the prescription drug bill now under debate. The amendment, to be offered by Sen. Mitch McConnell, R-KY, includes many of the reforms supported by the ACC, including periodic payment of future damages and the elimination of double payment of awards. The amendment, however, does not include a cap on noneconomic damages—a provision that the ACC strongly supports.

FDA Advisory Committee Votes Against Omapatrilat, For Statin/Aspirin Combo
The FDA Cardiovascular and Renal Drugs Advisory Committee has recommended against the agency approving Bristol-Myers Squibb's (BMS) vasopeptidase inhibitor omapatrilat (Vanlev) for the treatment of hypertension. The committee voiced concern about the increased risk of angioedema seen in the patients given omapatrilat in the OCTAVE trial. In a reversal of decision from last January, however, the advisory committee voted in favor of allowing BMS to market a product that would package together pravastatin (Pravachol) and low-dose aspirin. The package would include either a 20 mg, 40 mg, or 80 mg pravastatin and either an 81 mg or 325 mg aspirin. According to a Reuters report, it is anticipated that BMS will ask for approval of a single statin/aspirin tablet.

Anthem Acquisition of Trigon Approved
Anthem, Inc., the nation's fifth largest health insurer, has been given the go ahead by Virginia state officials to acquire Trigon Healthcare, Inc., the state's largest managed care company. Anthem operates Blue Cross and Blue Shield plans in eight states and has more than 8 million members. Trigon has 2 million members. The ACC recently joined with the American Medical Association and 22 national and state medical societies in a letter to Anthem protesting its unfair coding practices and onerous contract provisions, including provisions that allows Anthem to bundle CPT® codes, but does not allow physicians to challenge the appropriateness of the bundling practice.

New NCCI Edits Added for Version 8.3
Additional edits have been added for the National Correct Coding Initiative (NCCI) version 8.3, effective October 1, 2002. The edits were added to the NCCI without giving physician groups the opportunity to comment on them. According to an ACC review, there are several edits related to interventional and electrophysiology procedures. A more detailed article on the edits is now available on the ACC Web site.

Senate Approves Carmona as New Surgeon General
The Senate has unanimously confirmed President Bush's nomination of Arizona trauma surgeon Richard Carmona, MD, to be the next Surgeon General. Dr. Carmona should be sworn in some time in the next two weeks. The vote to approve Dr. Carmona was unanimous, despite considerable debate during the nomination hearing about his qualifications for the position. According to an Arizona Daily Star report, Dr. Carmona has said that he will focus his work as Surgeon General on fighting smoking, obesity, and diabetes.

FDA Approves OTC Device to Treat Hypertension
The FDA has approved an over-the-counter device to treat hypertension, InterCure, Inc.'s Resperate. According to an InterCure statement, Resperate includes a respiration sensor that is worn around the torso and automatically analyzes users' breathing rate and pattern and, via headphones, interactively guides users through breathing exercises that slow their breathing to less than 10 breaths per minute. The Resperate, the company stated, "has been clinically validated to significantly lower blood pressure by an average of 14 mmHg systolic and 9 mmHg diastolic after eight weeks of routine use (15 minutes per day, 3-4 times per week)." Older patients and those with a higher baseline blood pressure experience even greater reductions on average, the company added.

Funding for Smoking Prevention Programs Victim of State Budgetary Woes
States' smoking and other tobacco prevention programs, funded in large part by the 1998 national tobacco settlement, will be cut by more than $102 million in 2003. The cuts are a result of the significant budget shortfalls being experienced in nearly every state. According to a report by the Campaign for Tobacco-Free Kids, states like California, Arizona, and Massachusetts—which have had great success with these programs—are making some of the deepest cuts, from 35 to 50 percent. The report also found, however, that some states will actually increase spending on tobacco prevention programs in 2003, including Indiana, Maine, Maryland, and New Jersey.