American College of Cardiology

ACC Members Take to the Hill This Week
More than 140 ACC members will be in Washington, DC, this week to urge their legislators to prevent cuts in Medicare fees in 2004 and to enact medical liability reform. The visits to Capitol Hill will be part of the ACC’s annual legislative conference, during which ACC leadership and members of the key contact system meet one-on-one with their legislators and their staff. ACC members are encouraged to contact their legislators about both Medicare fees and medical liability reform using the ACC’s Web-based legislative action center.

CMS Weighing Whether to Accept Legacy Claims After Oct. 16
The Centers for Medicare and Medicaid Services (CMS) said last week that it is still weighing its options around the Oct. 16 deadline for compliance with the HIPAA transaction and code set standards. In a written statement, CMS Acting Deputy Administrator Leslie V. Norwalk said the CMS “is actively assessing the readiness of its trading partners to make sure that cash flow to Medicare fee-for-service providers will not be disrupted.” Based on that assessment, she explained, the CMS will decide whether to implement its contingency plans, which will include continuing to accept and send transactions in legacy formats “while trading partners work through issues related to implementing the HIPAA standards.” The contingency plan decision will be made by Sept. 25. Norwalk also urged health plans “to announce their contingency plans as soon as possible.” The CMS does not have the authority to require private payers to accept non-HIPAA compliant claims after Oct. 16.

The ACC continues to engage in discussions with the Bush administration and members of Congress about the potential for serious disruptions to the health care system if non-HIPAA compliant claims are not accepted by Medicare carriers and private payers. For more information on the transaction and code set standards, including recommended contingency plans, visit the ACC HIPAA Resource Center or read the latest HIPAA news from the September issue of Cardiology.

Medicare Reform Conferees Addressing Rural Provider Provisions
The House-Senate Medicare reform conference committee has begun work on provisions that would increase payments to rural providers. Senate Finance Committee Chair Charles Grassley, R-Iowa, has been rural providers’ strongest proponent, which is reflected in the $18.2 billion in increased payments for rural, inpatient hospitals in the Senate-passed bill. According to a Health News Daily report, the House bill only provides for an additional $6.3 billion in payments. The House-Senate conferees made some progress last week, agreeing on the introduction of a drug-discount card for low-income seniors.

Calif. CABG Report Card Criticized for Providing Old Data
The results of a new survey of California hospitals’ performance with CABG procedures is coming under some criticism because its data date back nearly four years. The survey is based on data collected from 70 hospitals from 1997 to 1999. Participation in the survey was voluntary; 49 mostly smaller hospitals opted not to participate. Generally, the survey showed that hospitals that performed more CABG procedures had better results. According to a San Francisco Chronicle report, under a new state law, all of the hospitals in the state that perform CABG procedures are required to participate in the next survey, the results of which will be released in 2005. The ACC California Chapter was involved in designing the reporting model for the next survey and, under the new law, will play a central role in disputes about data and other aspects of the reporting program.

Medical Liability Reform Expected to Return to Congress’ Agenda
Senate Republicans now appear committed to considering an obstetrics-only medical liability reform bill as early as October. Holding a Senate floor vote on a bill that would provide medical liability protections, including a cap of $250,000 on noneconomic damages, for obstetric services only is part of a larger incremental strategy on medical liability reform now being advanced by the GOP leadership. Rumors are that the obstetrics bill would be followed by legislation providing liability protections for emergency services. Although it is difficult to predict how this strategy will play out, Republican leaders have said they would continue with incremental votes next year, proceeding to protections for rural providers and good Samaritans, and would eventually seek passage of legislation that provides protections to all physicians. The ACC and the Alliance of Specialty Medicine continue to push for enactment of legislation this year, and have begun preparations to take the battle up again in 2004.

Senate HHS Appropriations Bill Passed With Minimal Increase for NIH Funding
The Senate has passed a 2004 HHS appropriations bill that includes only a 3.7 percent increase in funding for the National Institutes of Health (NIH), far less than had been requested by many in the medical community, including the ACC. Sens. Arlen Specter, R-Pa., Dianne Feinstein, D-Calif., and Tom Harkin, D-Iowa, had introduced an amendment that would have added $1.5 billion to the 2004 NIH budget, but it failed to gain enough support to be included in the final bill. The House has already passed its HHS appropriations bill, also with a minimal increase for NIH. A House-Senate conference committee will be convened to work out the differences between the two bills. The ACC will continue to push for increased NIH funding throughout the conference committee process.

CMS Reverses Course on NCCI Edit on EP Procedure
The ACC and NASPE/Heart Rhythm Society were successful in getting the CMS to change a proposed national correct coding initiative (NCCI) edit that would have prevented CPT codes 33210, insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter, and 92960, external cardioversion, from being billed together. The ACC objected to the proposal, arguing that there is no evidence to suggest misuse of this code combination and that they are applied to different clinical conditions. The new NCCI edits, version 9.3, are effective Oct. 1. As reported last week, the NCCI edits will now be posted on the CMS Web site. Previously they were available only in print form and had to be purchased by providers.