Cardiology Payments Affected By Proposed Five-Year-Rule
The Centers for Medicare and Medicaid Services (CMS) released a notice of proposed rulemaking last week that outlines proposals for major changes to Medicare's Resource Based Relative Value System. If CMS implements the proposed changes, aggregate Medicare payments to cardiologists would decrease by an estimated 1 percent in 2007 compared to 2006. While the outcome is by no means ideal, CMS heard the cardiovascular community's pleas to utilize more current, supplemental practice expense data provided by the ACC, ASE, ASNC, HRS, and SCAI – without which the impact would have been much more severe. The impact on individual practices will depend on the mix of services provided to Medicare patients. The projected impacts do not take into account the annual changes to Medicare's conversion factor, which is expected to decrease by 4.6 percent in 2006 unless Congress intervenes. In addition, other adjustments to maintain budget neutrality may be required. CMS may also announce additional policy changes that could affect cardiology payments in another proposed rule to be released later this summer. To read the CMS release, click here. For more information contact Rebecca Kelly (rkelly@acc.org) or Denise Garris (dgarris@acc.org).

CPCI Briefing for Key Hill Staff
Approximately 40 key congressional staff attended a Coalition for Patient Centered Imaging (CPCI) briefing last week and learned about the formulas under which Medicare pays for services performed in the hospital outpatient and physician office settings. Given the changes in reimbursement for imaging services under the Deficit Reduction Act—and with numerous payment changes anticipated for 2007—the briefing provided an opportunity for staff to learn about how the different payment structures function. The briefing included an informative presentation by two Medicare reimbursement experts, Dr. Bart McCann and Mr. Tom Ault, of Health Policy Alternatives. CPCI owes a special thanks to Reps. Phil Gingrey, M.D., (R-GA) and Michael Burgess, M.D., (R-TX) who secured a room and circulated a “Dear Colleague” to invite attendees.

Senate Hearing Examines Medical Liability Reforms
Senate Health Education Labor and Pensions (HELP) Committee Chairman Michael Enzi (R-WY) held a hearing last week to examine alternative medical liability reforms, including health courts. The hearing looked at a bill sponsored by Enzi and Sen. Max Baucus (D-MT) that would fund state demonstration projects to test heath courts, awards by state administrative boards, or early disclosure and compensation programs. Health courts received a lot of attention during the hearing, with supporters saying that they could reduce the number of meritless claims and lower costs associated with litigation and opponents saying that they deny injured patients access to a jury trial. Meanwhile, Doctors for Medical Liability Reform (DMLR) continues to build its grassroots network in support of reform. DMLR, to which the ACC belongs, has developed a Patient Outreach Kit for physician offices, including a packet of informational brochures including tear-off petitions for patients and physician to sign and mail in. Click here to order your kit today.

FDA Issues Class 1 Recall for Welch Allyn AED 20™
The FDA has issued a Class 1 Recall for the Welch Allyn AED 20™ Automated External Defibrillators manufactured from April through Oct. 2003, serial numbers 205199 through 205786. The devices are intended for use by emergency or medical personnel to treat adult and pediatric patients in cardiopulmonary arrest. They are used to analyze an unconscious patient’s heart rhythm and automatically deliver an electrical shock to the heart if needed to restore normal heart rhythm. According to the FDA, an electrical connection within the recalled devices may fail intermittently, impairing the device's ability to analyze the patient’s heart rhythm and deliver appropriate therapy. This could result in delay or failure to resuscitate the patient. This may be associated with an error message on the device display reading “DEFIB COMM FAIL SELF TEST FAILED.” To read the complete recall notice, click here.

Guidant, FDA Warn About ICD Malfunctions
Guidant and the FDA have notified healthcare professionals and patients that a subset of implantable pacemakers, cardiac resynchronization therapy pacemakers and implantable cardioverter defibrillators [ICDs] is associated with five reports of device malfunction due to the failure of a low-voltage capacitor from a single component supplier. Patients with affected pacemakers may experience intermittent or permanent loss of output or telemetry or premature battery depletion. Patients with affected ICDs may experience inappropriate sensing or premature battery depletion. Physicians are asked to perform an exam as soon as possible to assess device function for all patients with implanted devices from this subset. For the complete warning, click here.

New Study Examines Costs Associated With Implantable Defibrillators
A new analysis, published in the June 20 edition of the Journal of the American College of Cardiology (JACC), found that one of every 10 Medicare patients fitted with implantable defibrillators has complications resulting in longer hospital stays and millions in additional costs. According to the study, which looked at 31,000 cases, complications add $70 million to $75 million to the costs borne by Medicare and private insurers for the 100,000 defibrillators implanted each year. The study is the largest of its kind and the first to examine complication rates among the full range of doctors and hospitals that implant defibrillators, not just the top doctors and major medical centers that typically conduct research trials. To read the USA Today article on the analysis click here. For the current issue of JACC, click here.

Register Now for ACC’s 2006 Legislative Conference
Registration is now open for the ACC’s 2006 Legislative Conference taking place Sept. 17-19 at the Renaissance Mayflower Hotel in Washington, D.C. Don’t miss this opportunity to educate members of Congress about Medicare physician payment, in-office medical imaging, health information technology and other key issues facing the cardiovascular community. The three-day event will begin with a reception and dinner to celebrate the opening of the ACC’s new headquarters in Washington, D.C. Education sessions and an exciting event to benefit the ACC’s Political Action Committee (PAC) will follow. The conference will culminate with face-to-face meetings with lawmakers on Capitol Hill. Don’t miss out! Registration is $100 for members and $50 for FITS and CCAs. To register, click here. To view the conference agenda, click here. Note: The ACC is providing 15 travel awards of up to $1,000 each to FITs. Interested participants should send an email to fitlegaward@acc.org with their address, name of training program, year of training, and congressional voting district. Awards will be announced on July 9.