American College of Cardiology

Senate Readies for Vote Week of April 5 on Medical Liability Bill
The ACC is calling on its members to contact their senators in support of S. 2207, the "Pregnancy and Trauma Care Access Protection Act." The Senate Republican leadership has signaled its desire to bring to the Senate floor the second of what is expected to be a series of incremental bills on medical liability reform. As early as next week, the Senate could debate and vote on S. 2207, which would provide medical liability protection to emergency, trauma, obstetrical and gynecological care services. On Feb. 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 only. The provisions contained in S. 2207 are nearly identical to the medical liability reform bill (H.R. 5) passed by the House last year. H.R. 5 was strongly supported by the ACC, is patterned after California's MICRA law, and includes a $250,000 cap on noneconomic damages. Under the new bill, services provided to individuals with an emergency medical condition-including the response to the medical condition, screening stabilization, and treatment-would be afforded liability protections. Call, write, or fax your senator no later than April 5 and tell them to support S. 2207. ACC members can send an email to their senators directly from the ACC Advocacy Web page by simply clicking on the "Take Action Now" icon.

Get Ready To Kick Butts Against Tobacco
The ACC is proud to announce its participation in the Campaign for Tobacco-Free Kids' ninth annual Kick Butts Day. On March 31, advocates in the fight against tobacco from around the country will join forces to help Americans kick the deadly habit of tobacco use. The Kick Butts Day motto is "STAND OUT...SPEAK UP...and SEIZE CONTROL in the fight against Big Tobacco." ACC members are encouraged to boost their patient education efforts about the dangers of tobacco use and the benefits of quitting. Go to www.kickbuttsday.org for patient education materials.

Reminder — ACC District Advocacy Period
Don't forget about the ACC District Advocacy Period, which runs April 5 - 16. To learn more click here, or contact Melissa Stamps in the ACC Advocacy Division for either program at 1-800-435-9203.

ACC Minnesota Chapter Supports Physical Education Requirement in Schools
The Education Policy Committee of the Minnesota House legislature is considering legislation that would amend academic standards to include health and physical education requirements in all levels of school curriculums. The bill, HB 2209, sponsored by state Sen.David Tomassoni would require 150 minutes of physical education per week for elementary students, 225 minutes per week for middle and high schools students, and all students would have 50 hours of health education instruction. Currently, the state has no such mandates, and physical and health education class offerings have decreased with budget cuts over the last few years. ACC's Minnesota Chapter President, Scott R. Wright, M.D., says, "the Minnesota chapter supports this bill and all efforts to promote more physical education among children. We believe it is one step of many that are needed to promote lifetime fitness and health and hope it will begin to stem the tide of the growing pandemic of obesity among school age children."

"Women Have Heart" Resolution Passes in House of Representatives
On Mar. 24, HR 522, the "Women Have Heart Resolution," passed by a unanimous vote in the House of Representatives. The resolution, sponsored by Rep. Vic Snyder (R-AR), expresses the sense of the House that there is a critical need to increase awareness and education about heart disease and the risk factors of heart disease among women. The resolution was originally introduced Feb. 10, 2004 and received an official letter of support from then ACC President Carl J. Pepine, M.D. on behalf of the College.

Prescription Drug Reimportation Task Force Holds First Session
The Task Force on Drug Importation, holding its first of six "listening" sessions on March 19, heard from several speakers including Peter Wyckoff, executive director of the Minnesota Senior Federation, Gail Shearer, director of health policy analysis for Consumers Union, and David Certner, director of federal affairs for AARP. Wyckoff commented "the issue is not about drug importation, it is not about prescription drug safety. The issue is about the cost of prescription drugs for all Americans" (Los Angeles Times, 3/20). Surgeon General Richard Carmona is chair of the task force appointed March 16 by Health and Human Services Sec. Tommy Thompson. The next listening session is scheduled for April 13. Meanwhile, the Food and Drug Administration continues to pursue efforts by government leaders to enable drug importation. Wisconsin Gov. Jim Doyle received a letter of concern from the FDA about Wisconsin's Web site. The state of Wisconsin has designed a Web site to help citizens order prescription drugs from Canada. The FDA's letter reminds the governor that importation of prescriptions is illegal and also expresses concern about the potential danger for individuals who take drugs from unauthorized outlets.

CMS Issues Guidance on Specialty Hospital Moratorium
The Centers for Medicaid and Medicare Services (CMS) has issued guidance for exceptions to the specialty hospital moratorium enacted last year as part of the new Medicare law. The moratorium, which expires June 5, 2005, prohibits physicians from referring patients to specialty hospitals in which they hold an interest. The "change request," as the guidance document is known, clarifies that the moratorium "applies to hospitals that are primarily or exclusively engaged in the care and treatment of patients with cardiac or orthopedic conditions, patients receiving surgical procedures and patients receiving any other specialized types of services that CMS may designate." Psychiatric, rehabilitation, children's, long-term-care and cancer hospitals are not included because they are not paid under the prospective payment system. Also, the moratorium does not apply to a class of hospital projects that were "under development" as of Nov. 18, 2003. Hospitals under development include those whose architectural plans were completed, whose funding was received, whose zoning requirements were met and whose necessary state approvals were received before Nov. 18, 2003.

Congress To Address Medicare Pay Formula
Sen. Jim Bunning (R-KY), at the request of the Alliance of Specialty Medicine, attached a resolution to the fiscal year 2005 (FY 05) Senate budget resolution that expresses the sense of the Senate that action by Congress is "urgently" needed to put in place a new formula or mechanism for updating Medicare physician fees in 2006 and beyond. The resolution, which does not have the force of law, also states that CMS should use its discretion to exclude drugs and biologicals administered incident to physician services from the payment formula and to more accurately adjust the formula to reflect the impact on spending for physicians' services of new coverage decisions, new rules and regulations, and changes in law. Similar language was inserted by House Budget Chairman Jim Nussle, R-Iowa , into the report language of the House budget resolution. Even though Congress stepped in last year to prevent cuts in physician payments in 2004 and 2005, reductions of 5 percent are expected each year for several years beginning in 2006. In its March report to Congress, the Medicare Payment Advisory Commission (MEDPAC) did not offer any suggestions about how to alter the payment formula.

Nuclear Imaging: A Boost for the Bottom Line or Not?
According to a report from the Medical Group Management Association (MGMA), nuclear imaging as a new line of business for cardiology practices, although an increasingly popular ancillary service, has not boosted the bottom line for those who have used it and it hasn't necessarily offset the increased costs for some. The respondents to MGMA's survey indicated that whereas their medical revenues had increased by 6.42 percent in 2002, operating costs had increased by 6.2 percent. Overall, respondents indicated a 2.2 percent drop from 2001 to 2002 in total revenues after accounting for operating costs. With the overall revenue drop, increased revenues from nuclear imaging did not seem to make a significant difference for many. (Modern Healthcare, Mar. 17)

Medical Group Staffing, What Is Adequate—An Upcoming Audio Conference Event
On April 8, the ACC is pleased to offer another Medical Group Management Association (MGMA) audio conference, "Rightsizing the Medical Group's Staff: How many is too much, how few is not enough?" The conference will examine the relationship between staffing levels and practice profitability. The purpose of the conference is to help participants identify the impact that specific staffing development models have on efficiency, productivity, and profit. The 90-minute call will be presented at the following times: 2 - 3:30 p.m., ET; 1 - 2:30 p.m., CT; 12 - 1:30 p.m., MT; 11 a.m. - 12:30 p.m., PT; 10 - 11:30 a.m. Alaska; and 9 -10:30 a.m., Hawaii. This audio conference is also an opportunity to receive ACMPE, CME, CPE, and nursing credits. To learn more about participation, go to http://www.acc.org/pmr/payer_advocacy.htm or contact Mia Thomas, ACC Payer Advocacy at 800-435-9203.