American College of Cardiology

CMS Releases Final 2009 Medicare Physician Payment Rule

The Centers for Medicare and Medicaid Services (CMS) last week released the final 2009 Medicare Physician Fee Schedule, which includes some good news for cardiology in terms of administrative burden, but some unfortunate news about physician payment. While ACC staff continues to review the rule in detail, highlights include the following:

• IDTFs: Thanks to the combined efforts of ACC and other cardiovascular specialty societies, CMS is deferring a final decision on its proposal to require physician practices that provide diagnostic testing services to register as IDTFs.
• Payment Rates: Although Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) put in place a 1.1 percent update to the Medicare conversion factor, CMS projects that overall Medicare payments to cardiology will fall by 2 percent in 2009. This cut results primarily from two policy changes: the transition to a new formula for calculating practice expense relative value units (RVUs) and the budget neutrality adjustment provision of MIPPA.
• Coding Changes: CMS also announced the payments for a series of new codes related to cardiac device monitoring, as well as new bundled codes that describe transthoracic echocardiography with spectral and color flow Doppler and stress echocardiography with stress ECG monitoring. The ACC and MedAxiom are holding a special Webinar to address these changes on Nov. 14. Click here to register.

The final rule also includes detailed requirements for the 2009 Physician Quality Reporting Initiative (PQRI) and electronic prescribing (e-prescribing) and increases bonus payments for participation to 2 percent for each program. The final rule also adds additional reporting methods, including using the ACC's IC3 Program® as a reporting alternative. More coverage of the rule is available here.

ACC Holds 7th Annual Medical Directors’ Institute

The ACC from Oct. 28 – Oct. 30 held its seventh annual Medical Directors’ Institute (MDI). The meeting, which had more than 100 participants, including ACC leaders, health plan representatives, and other stakeholders, focused on “efficiency,” and the lack of a standardized definition among payers, physicians, policymakers and patients about what that means. In an effort to address this issue, MDI participants heard from the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, and public, private, for-profit and non-profit stakeholders about their strategies, initiatives and challenges in the health care efficiency arena. Participants had the opportunity to identify areas of convergence and opportunities for alignment, while also providing concrete ways for cardiology to influence and improve efficiency in collaboration with key stakeholders. For more information, including presentations, view the MDI Web site.

CMS to Hold Conference Call on ICD-10

Registration is now open for a Centers for Medicare & Medicaid Services (CMS) conference call for physicians discussing the International Classification of Diseases Version 10 (ICD-10). CMS has proposed a transition to ICD-10 from ICD-9 beginning Oct. 1, 2011. The call will be held on Nov. 17 from 12:30 – 2:30 p.m. EST. More information is available on the CMS Web site, or to register, click here.

FDA News Updates

The Food & Drug Administration (FDA) recently sent warning letters to Bayer HealthCare in regards to two over-the-counter aspirin products – Bayer Women’s Low Dose Aspirin + Calcium and Bayer Aspirin with Heart Advantage – because they contain aspirin combined with either phytosterols or calcium. Both products are labeled for use in reducing the risks of heart disease, and Bayer Women’s is labels for use in “fighting” osteoporosis. The drugs require an approved new drug application to be legally marketed, which neither has received. More information is available here.

Medtronic has begun to market its Talent thoracic stent graft, which was recently approved by the FDA, for the Xcelerant delivery system for treatment of thoracic aortic aneurysms. The stent graft is intended to expand to more patients with thoracic aortic aneurysms the opportunity for thoracic endovascular aortic repair. More coverage is available from Cardiovascular Business Magazine.

The FDA recently granted approval for Boston Scientific’s Carotid Wallstent Monorail Endoprosthesis for high surgery risk patients with carotid artery disease. The stent is self-expanding with a closed-cell design and is intended to reopen the carotid artery by treating stenoses and improving blood flow to the brain. More coverage is available from Cardiovascular Business Magazine.

Lewin Report Features ACC President as Guest Blogger

ACC President Doug Weaver, M.D., F.A.C.C., this week was featured as a guest “blogger” on The Lewin Report, an online discussion forum for ACC members. In his post, “Value-Based Care: Sustaining an Unsustainable System,” Dr. Weaver writes,

The rate of expenditure growth is both unacceptable not sustainable. As important is the fact that despite these rising costs, there is evidence that we are actually lagging in the provision of evidence-based care—by many measures we are slipping in producing a healthier America. Because of this, there can be no doubt ... [read more]

Do you agree with Dr. Weaver? Continue the discussion at lewinreport.acc.org. Dr. Weaver’s column is part of a new series of guest posts by ACC leadership. Check back next month to see which ACC leader is sharing his or her thoughts on health care reform!

Md., Ks. Hold ‘Cardiologist for a Day’ Programs

The Kansas and Maryland Chapters both recently held a “Cardiologist for a Day” program. In Maryland, Delegate Shane Pendergrass, vice chair of the House Health Committee, and Delegate Kirill Reznick, on Oct. 29 toured the office of Chapter Governor-elect Sam Goldberg, M.D., F.A.C.C. During the visit, Dr. Goldberg showed the delegates the in-office imaging options available. After, the delegates visited Suburban Hospital, where staff demonstrated the types of CT scans that, because of a Maryland law that prohibits certain kinds of in-office imaging, Dr. Goldberg is unable to perform in his office. The delegates both pledged to work closely with the ACC on efforts to overturn the law. The Maryland Chapter will meet with House Speaker Michael Busch on Nov. 13, and will testify about the importance of overturning the law before the House Health Committee on Dec. 3.

In Kansas, state and national lawmakers and state regulatory officials participated in a “Cardiologist for a Day” program at the Cotton-O’Neil Heart Center and Stormont Vail Hospital. Chapter President Thomas Doyle, M.D., F.A.C.C., Chapter Executive Tonya Ferguson and ACC staff discussed with participants the burden of heart disease in the state, the importance of patient detection and prevention of heart disease and the large number of uninsured Americans. The event was a great success, earning coverage by a local TV station and raising the profile of cardiovascular professionals in the state.