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ACC
2004 Annual Meeting Advocacy Highlights
Advocacy
Weekly
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ACC
2004 Annual Meeting Advocacy Highlights
First Lady Speaks to ACC’04 Attendees
in New Orleans
Speaking at the Presidential Plenary Session on Mar. 8 at
ACC’04 in New Orleans, First Lady Laura Bush urged cardiovascular
specialists to educate women patients about their risks for
heart disease, to volunteer to conduct heart-risk screenings
as part of the National Heart, Lung, and Blood Institute’s
Heart Truth campaign (NHLBI), and to talk to colleagues in
primary care and emergency medicine about women’s risks.
Mrs. Bush noted that women who make healthy behavior modifications
decrease their risk of heart disease by as much as 82 percent.
Later that afternoon, Mrs. Bush helped to open the NHLBI Red
Dress Collection display in the convention center. The dresses
were on display throughout the Annual Scientific Session.
Both
Sides Agree: Health Care Issues a Major Focus in 2004 Elections
In introductory remarks at the ACC’04 "Health Care
and Elections 2004" session in New Orleans, Dr. John Schaeffer,
co-chair of the ACC Advocacy Committee, advised physicians to
stay informed and pay attention to this year’s election
messages. The two partisan experts who spoke at the session
called health care issues among the most important in this year’s
election. Political strategist, Ed Goeas of the Tarrance Group,
a Republican polling firm identified the dominant election issues
to be Medicare, health care, education, taxes, and morality.
Goeas commented that voters believe that health care is a right,
not a privilege and therefore have little tolerance for both
the number of uninsured and increased costs, thus creating a
difficult political challenge. Celinda Lake of Lake, Snell,
Perry & Associates, representing the Democratic counterpart,
forecast that voter turnout would be the key to winning, and
that unmarried women have the potential to influence the outcome.
According to Ms. Lake, voters will focus on health care access,
quality, and choice, are concerned about health care costs and
tend to view them as part of overall major economic stressors.
Both agreed that voters are beginning to view medical liability
as a key personal cost also and blame profit-taking health care
management companies for the problem.
Symposium Offers Agency Views
on Off-Label Usage
The ACC 04 Health Policy Symposium brought together representatives
from the Food and Drug Administration (FDA), Centers for Medicare
and Medicaid Services (CMS) and Federal Trade Commission (FTC),
to shed light on the increasing trend of off-label use of drugs
and devices. Commenting that the problem of off-label use begins
with the definition itself, Deborah Wolf, JD, regulatory counsel
for the FDA Office of Compliance, directed physicians to a new
FDA Web page that contains detailed information on approved
products. Ashley Boam, MSBE, chief of the FDA's Interventional
Cardiology Devices Branch, called on physicians and industry
to construct research trials that better reflect diversity,
noting that off-label uses sometime arise from the restrictive
nature of clinical trials. Steve Phurrough, MD, director of
CMS's Coverage and Analysis Group, said the Center leaves decisions
on whether to cover off-label use to local carriers and emphatically
stated that CMS is not planning any policy to prohibit coverage
of off-label indications. Matthew Daynard, JD, senior attorney
in the FTC's Division of Advertising Practices, noted that the
FTC does not differentiate between drugs and devices used in
accordance with approved labeling or in an off-label manner.
Rather, the FTC focus is on whether claims made are substantiated
and truthful.
Advocacy Weekly
Senate Readies for Second Round
of Medical Liability Reform
During the week of March 29, 2004, it is expected that the U.S.
Senate will vote on medical liability reform legislation. The
"Pregnancy and Emergency Access to Care Protection Act,"
S. 2207, if passed would provide medical liability protections
on emergency and trauma care (including emergency cardiovascular
services) to the tune of a $250,000 cap on non-economic damages.
The bill also contains the provisions of S. 2061; the first
incremental liability measure would have extended liability
protections to obstetricians and gynecologists. The Senate Republican
leadership has signaled its desire to bring S. 2207 to the Senate
floor as the second of an anticipated series of incremental
bills on medical liability reform. On February 24, the Senate
blocked consideration by a vote of 48-45 of a bill that would
have provided medical liability protections to obstetricians
and gynecologists. The ACC is encouraging all ACC members to
contact their senators and tell them to support the "Pregnancy
and Emergency Access to Care Protection Act." The Senate
will be in recess March 13-21, and many senators will return
home for public events and meetings with constituents. To find
out whether your senator will be hosting or attending a public
event this week, call your senator's local office. To obtain
your senator's local office contact information, go to the Doctors
for Medical Liability Reform Web site and click on your
state.
Senate Passes Legislation Calling
for Medicare Fee Fix by 2006
On March 5, by voice vote, the Senate Budget Committee adopted
a Sense of the Senate Resolution calling for a new formula for
updating the Medicare physician fee schedule by 2006. In an
effort to keep the momentum and visibility for the issue, the
Alliance of Specialty Medicine, of which the ACC is an active
member, drafted and convinced Sen. Jim Bunning, R-KY, to introduce
the resolution which calls for both Congress and CMS to adopt
a new formula or mechanism for physician payments to ensure
the long-term stability of Medicare payments and continued patient
access to services. While a Sense of the Senate resolution does
not carry the weight of law, it does very tangibly reflect the
Senate's recognition of the ongoing problem, and its intent
to pursue a long-term fix. The Resolution was adopted in the
form of an amendment to the FY 2005 Budget bill.
CMS Limits 14-Day Period to HIPAA-Compliant
Claims
CMS is modifying its HIPAA implementation plan that provided
for electronic media claims (EMCs) submitted in a pre-HIPAA
format to be accepted temporarily after October 15, 2003. As
of July 1, 2004, only EMCs
that are compliant with the HIPAA transactions standards
will be eligible for payment 14 days after the date of receipt.
CMS says that this operational change, effective July 1, 2004,
is meant to encourage compliance with HIPAA standards requirements
as soon as possible. All other claims, including paper and non-HIPAA-compliant
EMCs, will be paid no sooner than 27 days after they are received.
ACC has resources do deal with HIPAA, specifically the “How
to Manual” for compliance for claims processing, to view
go to http://www.acc.org/pmr/hipaa/hipaa.htm
E-Prescriptions Part of the Future
in Medicare
A lesser known section of the recent Medicare act provides for
a future systemwide switch to e-prescriptions for Medicare patients.
The goal of e-prescribing
is to eliminate handwriting errors, confusion on medication
names and dosages, and drug interactions; to reduce the number
of callbacks to a physician's office; and to encourage the effortless
movement of a prescription to a patient's chosen pharmacy. According
to a 1999 study by the Institute of Medicine, the high cost
of medication errors caused by illegible handwritten prescriptions
or avoidable drug interactions runs more than $1 billion a year.
Plans are for the U.S. Department of Health and Human Services
(HHS) to develop a set of standards for prescriptions transmitted
electronically; release these rules in 2005, and then conduct
a one-year, e-prescription pilot program in 2006. HHS is to
report back to Congress with the program's results in April
2007, with final standards to be issued later that year.
Senate Confirms McClellan as
CMS Head
The Senate confirmed Mark McClellan’s appointment as administrator
of the Centers for Medicare and Medicaid Services (CMS) early
Mar. 12. Sen. Byron Dorgan (D-SD) who had blocked early efforts
for a floor vote because of McClellan’s opposition to
drug reimportation. allowed the vote to go forward when he realized
that Sen. Bill Frist (R-TN) had secured the votes necessary
for confirmation. Dorgan also said that Frist had agreed to
begin a process that could lead to legislation that would allow
the reimportation of lower-cost, U.S.-manufactured prescription
drugs from other nations. (AP/Houston
Chronicle) The efforts of Sens. Dorgan and John McCain
(R-AZ) to bring the issue of drug reimportation to the forefront
by holding up McClellan’s confirmation seems to have been
successful. The administration faces a groundswell of support
for legal importation of drugs as Sens. Trent Lott (R-MS) and
John Cornyn (R-Tex.), among others, now indicate their support
for importation legislation.(Washington
Post)
FDA Launches New Easy-to-Use Drug
Information Web Site
On Mar. 3 the Food and Drug Administration (FDA) launched a
new web site to help consumers and health professionals find
information about FDA-approved drug products more quickly and
efficiently. The new interface, Drugs@FDA is a searchable database
that includes information on approved prescription drugs, some
over-the-counter drugs, and discontinued drugs. Located on the
Center for Drug Evaluation and Research (CDER) Web page, the
site provides a complete overview of a drug product's approval
history. Drugs@FDA makes all drug approval information available
on one site by establishing a database that incorporates information
from all parts of CDER's Web site, including Consumer Information
Sheets, Medication Guides, labeling, and other information.
Eventually information on recalls, warnings, and drug shortages
will be included. More information, as well as access to the
site, is available at http://www.fda.gov.
Projected Obesity among Elderly
May Consume Medical Dollars
A study conducted by the Rand Group think tank in Calif. projects
that by 2020 medical problems related to obesity will consume
one in five health care dollars in people aged 50 – 69.
The study predicts that growing obesity among older Americans
could reverse the health gains this group has experienced due
to their reduced exposure to disease, better medical care, and
changing behavior, including smoking habits. Severely obese
older people are more than twice as likely as people of normal
weight to be in fair or poor health and have about twice as
many chronic medical conditions. The study, in the current edition
of Health
Affairs, found a 44% increase in health-care costs
among people who are moderately or severely obese, compared
with those of normal weight. The study flies in the face of
some earlier evidence that older Americans are getting healthier,
causing disability rates to drop.
Advocacy
Weekly is a product of the Advocacy Division of the American
College of Cardiology. Questions or comments regarding this
publication should be directed to the Advocacy Division at 800-435-9203
or to advocacydiv@acc.org. |
