American College of Cardiology

Senate Committee Holds Fourth Health System Reform Hearing
On July 17, the Senate Finance Committee held the fourth in a series of hearings on health system reform. At the hearing, witnesses and lawmakers discussed the causes of geographical differences in health care spending and potential solutions. Two potential solutions discussed were comparative effectiveness research and health information technology (HIT). A comparative effectiveness research center would encourage the completion of research necessary to address geographical differences in spending, according to Gail Wilensky, a senior fellow with Project Hope. Congressional Budget Office Director Peter Orszag testified that HIT alone is not sufficient to reduce spending, but can reduce costs in combinations with other changes to the health care system. Meanwhile, experts testified at a House Budget Committee on July 16 that new processes and incentives are needed to increase the value of the health care system. At the hearing, Orszag stressed the importance of focusing on preventative care and increasing incentives to reward quality over volume. For more information about ACC's health system reform campaign, visit the Quality First Web site at http://qualityfirst.acc.org.

CMS Announces PQRI Bonus Payment Awards
The Centers for Medicare & Medicaid Services (CMS) on July 15 announced that it will make more than $36 million in bonus payments to the more than 56,700 physicians participating in the 2007 Physician Quality Reporting Initiative (PQRI). Physicians who participated in the program should expect to receive payment in August. The average bonus payment to an individual physician is $600 and the average bonus payment to a group practice is more than $4,700. The largest incentive payment to a group practice is $205,700. In addition, participating physicians can begin accessing confidential feedback reports that aggregate the data they submitted and show how they compare with other participants. To access the reports, participating physicians and organizations must register for CMS' "Individuals Authorized Access to CMS Computer Services" (IACS). To do so, click here. To access the PQRI Portal, click here and for general information on PQRI, click here.

CMS Releases RAC Pilot Program Report
On July 11, the Centers for Medicare & Medicaid Services (CMS) released a new report touting the success of the recovery audit contractors (RAC) pilot program in identifying improper payments under the Medicare program. The RAC program, formerly a pilot program but required nationwide by Jan. 1, 2010, uses private companies on a contingent basis to identify over- and under-payments to Medicare. The CMS report found that the RAC program returned $693.6 million to the Medicare Trust Funds between 2005 and March 2008, after accounting for money repaid to providers and the operating costs of the program. Of the improper payments, 96 percent ($992.7 million) were overpayments and four percent ($37.8 million) were underpayments. Eighty-five percent of overpayments were collected from inpatient hospital providers, 6 percent from inpatient rehabilitation facilities and 4 percent from outpatient hospital providers. On the same day that the report was released, five House members requested that the Government Accountability Office (GAO) undertake a study of the program citing concerns with the program's implementation. Although significant changes have been made over the life of the program, the lawmakers requested that GAO make recommendations for future improvements. The report was requested by Reps. John Dingell (D-MI), Frank Pallone (D-NJ), Charles Rangel (D-NY), Pete Stark (D-CA) and Lois Capps (D-CA). The ACC shares concerns about the RAC program and will continue to work with the physician community to seek improvements, while also monitoring the program’s nationwide implementation.

FDA News Updates
The FDA last week released a preliminary public health notification alerting health care professionals to the potential for medical device malfunction during CT examinations. According to the notification, a small number of adverse events—including unintended "shocks," malfunctions of insulin infusion pumps and transient changes in pacemaker output pulse rate—have been reported in which CT scans interfered with electronic medical devices in patients. For more information, visit the FDA Web site by clicking here.

Meanwhile, the FDA has issued new information about recent changes made to the prescribing information for micro-bubble contrast agents. The revised Boxed Warning and Warnings outline the risk of serious cardiopulmonary reactions during or within the 30 minutes following the administration of these products. The warnings recommend that high-risk patients with pulmonary hypertension or unstable cardiopulmonary conditions be monitored during this time period. In addition, several contraindications were removed from the prescribing information. For more information, visit the FDA Web site by clicking here.

Only Two Days Remain To Register for First CBCCT Exam
Friday is the final deadline to register for the Certification Board of Cardiovascular Computed Tomography (CBCCT)'s first examination for certification in CCT. Qualifying ACC members are encouraged to apply for the exam, at a cost of $1,095.00, before the July 25 deadline. The exam, which will be held on Sept. 22, is offered in Prometric testing centers across the country and will consist of up to 200 multiple-choice questions, lasting 4.5 hours. Each question will include four choices, only one of which is the correct or best answer, and some questions involve the interpretation of images and figures. The questions are based on a fall 2007 analysis of the practice of CCT, which was intended to define the responsibilities, tasks and knowledge necessary for physicians to practice in the CCT field. A tutorial that includes sample questions is available online here. The Candidate Bulletins and application forms are available at the CBCCT Web site here.

Register Now: ACC’s 2008 Legislative Conference
Registration is now open for the ACC’s 2008 Legislative Conference in Washington, D.C. This year’s conference will take place Sept. 14 – 16 at the Fairmont Hotel. Don't miss this unique opportunity to help advocate for fair and sound policies that ensure cardiovascular specialists can practice medicine in a manner that provides the greatest value for patients. Participants will learn about key issues facing the cardiovascular community and be able to educate their respective lawmakers about the need for the cardiovascular community to be at the table when it comes to improving patient access, reforming Medicare and ensuring any new health care system moves beyond process to focus on outcomes. For more information, click here. Registration closes August 8.

Participation in Physician Practice Survey Critical
The ACC, the American Medical Association and more than 70 other organizations are conducting a comprehensive multi-specialty survey of America’s physician practices, the results of which the Centers for Medicare and Medicaid Services has indicated will be used to help determine physician payment. At this time, cardiology has one of the lowest responses of any specialty and it is crucial that anyone chosen to participate in the survey do so. 

The survey firm, dmrkynetec, has been retained to contact randomly selected physicians and practice managers to collect responses. All responses will remain confidential. Please alert your staff regarding your willingness to participate in this survey and the importance of accepting incoming calls, faxes or emails from dmrkynetec. A postcard was mailed to the entire physician sample on June 11. If you have been selected to participate in this important effort and have any questions about the survey, call toll-free at (877) 816-8940 and ask to speak with one of dmrkynetec’s executive interviewers about the 2008 Physician Practice Information Survey.  To see whether you have been selected to participate in the survey, go to: https://doanemrwebsc.com/onlinesurveys/amas/.

California Legislature Approves Trans Fat Ban
The California Legislature last week approved a bill that would ban trans fats in restaurants, hospitals and other food facilities by Jan. 1, 2010, except for use in deep frying, and in bakeries by Jan. 1, 2011. Under the bill, items containing less than 0.5 grams of trans fat per serving are considered trans fat free. Establishments that fail to comply with this ban could be fined up to $1,000. In addition, the bill allows for the creation of local ordinances related to trans fat. The bill is awaiting the signature of Gov. Arnold Schwarzenegger (R), who has not taken a position on the ban, according to a spokesperson. If it becomes law, the bill would make California the first state to ban the use of trans fat in all public food facilities.