American College of Cardiology

Mark Your Calendar: All-Member Call on Final Rule
The Centers for Medicare and Medicaid Services (CMS) is expected to release the final 2010 Medicare Physician Fee Schedule at the end of this month. As the Nov. 1 deadline approaches, we’ve pulled out all the stops to make sure that the drastic practice expense cuts proposed by CMS are not implemented. If this rule goes through as is, it will literally devastate the private practice of cardiology and outpatient access to cardiovascular care. ACC CEO Jack Lewin and President Alfred Bove, M.D., F.A.C.C., will host an all-member call on Nov. 12 from 4:00-5:30 p.m. (EST) to discuss the 2010 rule. To RSVP for the call, click here. For more on ACC’s efforts regarding the proposed rule, visit: http://qualityfirst.acc.org.

Senate Votes Against SGR Bill
The Senate on Oct. 21 voted against the "Medicare Physicians Fairness Act of 2009" (S. 1776), introduced last week. The bill would have repealed the sustainable growth rate formula (SGR) permanently and reset the budget baseline that is the primary obstacle to Medicare physician payment reform.

So what's next? The health care reform legislation passed by the Senate Finance Committee includes the one-year SGR "band aid," frequently used in the past to stave off the impending 21 percent cut scheduled for Jan. 1, 2010. It is probable that some variation of this solution will appear in the final health care package passed by Congress. In addition, Senate Budget Committee Chair Kent Conrad (D-N.D.) has called for a commission to develop a longer-term solution to the physician payment formula as well as other recurring budgetary problems. The ACC will continue to advocate for a permanent repeal of the SGR, and will keep you posted as these bills progress. More information on ACC's health care reform efforts is available at http://qualityfirst.acc.org. You can also share your thoughts on health care reform issues via the ACC's blog, http://lewinreport.acc.org.

Rep. McCarthy Defends In-Office Imaging
Rep. Carolyn McCarthy (D-N.Y.) is leading a letter to House leadership regarding provisions in the House health care reform bills that would reduce funding for many outpatient imaging services, such as CT and MR, by over 30 percent. The provisions could result in a reduction in the availability of in-office imaging. The letter concludes, “As we work diligently to provide all Americans with greater access to health care, we must ensure that the critical services of medical imaging remain available to all.” The ACC encourages members to call their representative and ask them to sign on to the McCarthy letter. Interested House members should contact the Legislative Assistant to Rep. McCarthy.

House Committee Approves Isotope Bill
The House Energy and Commerce Committee on Oct. 21 approved the "American Medical Isotopes Production Act of 2009” by voice vote. This bill would authorize $163 million over five years to start domestic production of molybdenum-99 (Mo-99) as soon as possible. Under the bill, the funds would be used to support private sector or research sector projects to establish domestic Mo-99 production. The bill now moves to the full committee.

In May, the Canadian reactor that usually supplies 60 percent of U.S. demand broke down and a major reactor in the Netherlands will shut down for necessary maintenance later this month. The Netherlands shutdown will leave the total global production capacity at approximately 10 percent of normal levels for one month. The ACC and other cardiovascular specialty societies endorse the legislation. More information about the shortages is available on the American Society of Nuclear Cardiology’s Web site.

MedPAC Discusses Hospital-Physician Integration
The Medicare Payment Advisory Commission (MedPAC) met earlier this month to discuss hospital-physician consolidation and the implications of the trend for the Medicare program.
Commissioners are concerned that consolidation leads to higher prices for private payers, which in turn may pressure Medicare rates and undermine the program’s fiscal sustainability. MedPAC commissioners also discussed whether there are regulatory and payment policies that may help Medicare blunt the effect of consolidation.

FDA News Updates
The Food and Drug Administration (FDA) recently approved AstraZeneca PLC’s hyptertention treatment for use in children and teenagers with heterozygous familial hypercholesterolemia. The approval is based on the results of the Pediatric Lipid Reduction Trial of Rosuvastatin (PLUTO) trial. In related news, the FDA also recently expanded the indication for telisartan (Micardis) to primary prevention in high-risk patients unable to take an ACE inhibitor, in particular ramipril.

ACC Position Statement: Comparative Effectiveness Research
The ACC on Monday released an advocacy position statement on “Principles for Comparative Effectiveness Research (CER),” published in the Journal of the American College of Cardiology. The statement outlines the ACC CER principles and what role the ACC can play in CER. It concludes: “The ACC is strongly supportive of a robust CER program that will better inform the health care decision-making of patients and their health care professionals.” Read the position statement in full.

Video: 2009 Legislative Conference
Video coverage of the 2009 Legislative Conference now is available from Cardiosource Video Network. Also check out ACC's blog, The Lewin Report, for additional coverage.

IOM Report: Secondhand Smoke and Cardiovascular Effects
A new Institute of Medicine (IOM) report, “Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence,” provides a comprehensive review of the science on the relationship between secondhand smoke exposure and acute coronary events. The report, which was requested by CDC, found the following:

• The evidence is consistent with a causal relationship between secondhand smoke exposure and acute coronary events, including acute myocardial infarctions.
• It is biologically plausible for a relatively brief exposure to secondhand smoke to precipitate an acute coronary event.
• There is a causal relationship between smoke-free laws and decreases in acute coronary events.

The report is available for purchase on the National Academies' website at http://www.nap.edu/.