| ACC
Comments on ENHANCE
The
ENHANCE (Effect of Combination Ezetimibe
and High-Dose Simvastatin vs. Simvastatin
Alone on the Atherosclerotic Process in
Patients with Heterozygous Familial Hypercholesterolemia)
trial results were released by Merck and
Schering-Plough Pharmaceuticals on Jan.
14. The results of the trial show no benefit
from the combination of ezetimibe (Zetia)
and simvastatin (sold together as Vytorin)
over simvastatin alone in terms of affecting
the rate of atherosclerosis progression.
The American College of Cardiology recommends
that major clinical decisions not be made
on the basis of the ENHANCE study alone.
This study deserves serious thought and
follow-up. The overall incidence rates of
cardiac events were nearly identical in
both treatment groups, and both medicines
were generally well tolerated. There should
no be reason for patients to panic.
Health care professionals
should speak to their concerned patients
using this drug. The ACC is also releasing
a public statement explaining that this
is not an urgent situation and patients
should never stop taking any prescribed
medications without first discussing the
issue with their health care professional.
Further research will be needed in this
area to provide conclusive evidence about
which lipid lowering strategy is preferred
(statin alone vs. statin plus ezetimibe).
Click
here to read the ACC’s official
statement on ENHANCE, or go to Cardiosource
for more.
Comment
on Draft Performance Measures
The ACC/AHA Task Force
on Performance Measures invites you to review
the draft ACC/AHA Clinical Performance Measures
for Primary Prevention of Cardiovascular
Disease in Adults. The Performance Measures
will be available for public comment from
Jan. 22 through Feb. 22. Click
here for the draft document and comment
form. Contact Melanie Shahriary at mshahria@acc.org
or (202) 375-6662 with questions.
On
Cardiosource: CAS Screening
Who should be screened for carotid artery
stenosis? Read this "10
Points to Remember" Journal Scan,
based on new guidelines.
Congratulations
to James Galloway, M.D., F.A.C.C.
Congratulations
to ACC member James Galloway, M.D., F.A.C.C.,
who will be promoted to Assistant Surgeon
General and Rear Admiral next month.
ACC
Comments on National Coverage Decisions
for INR Monitoring
The
ACC has submitted comments on a proposed
National Coverage Decision (NCD) for prothrombin
time (INR) monitor for home anticoagulation
monitoring. An industry coalition representing
providers of home INR monitoring services
requested a reconsideration of the existing
NCD for home INR monitoring, which limits
coverage to patients with mechanical heart
valves. The coalition requested that Medicare
expand coverage to all patients on warfarin
therapy for whatever reason and, failing
that, an expansion to patients with chronic
atrial fibrillation and deep vein thrombosis.
CMS opened the reconsideration in June and
the ACC submitted comments in July, recommending
that coverage be expanded for patients with
atrial fibrillation and congenital thrombophilic
disorders. CMS has now proposed to expand
coverage to patients with chronic atrial
fibrillation and deep vein thrombosis. The
ACC's latest comment letter supports the
proposed expansion; recommends that patients
with congenital thrombophilic disorders
be covered; addresses some logistical issues
with the proposed NCD language; and highlights
the lack of separate physician reimbursement
for managing patients on warfarin therapy
who are monitored remotely. CMS will issue
a final decision in mid-March.
UnitedHealthcare
Extends Imaging Accreditation Deadline
UnitedHealthcare
has extended the deadline for requiring
accreditation of specific cardiac imaging
services to the third quarter of 2008. The
initial deadline was March 1. The ACC played
a key role in getting the extension. UnitedHealthcare
will notify providers a minimum of 30 days
before accreditation becomes effective in
their area, or as otherwise required by
regulation. Additional information about
the imaging accreditation initiative is
available online at: http://www.UnitedHealthcareOnline.com.
Physician
Payment Likely to Be Focus of Senate Medicare
Legislation
Congressional
Quarterly last week reported that Medicare
physician payment could be the centerpiece
of any Senate Medicare legislation this
next year. According to Senate staff, the
legislation would likely include an 18-month-long
halt to a 10.6 percent cut to Medicare’s
physician payment rates now scheduled for
July 1. Stopping the July cuts and ensuring
a minimum 10-month payment fix without any
further cuts to medical imaging is one of
the ACC’s top priorities in the New
Year as well. The yearly battles over payment
cuts are unacceptable and continue to seriously
threaten physician abilities to provide
quality patient care.
To stay up to date on the latest Legislative
news and calls to action, join the ACC’s
CardioAdvocacy Network (CAN) at www.acc.org/can.
ACC staff is also seeking your feedback
on how continued Medicare cuts will impact
your practices, whether it’s providing
for staff, implementing EHRs, treating Medicare
patients, etc. This information is vital
when it comes to communicating with members
of Congress about finding a long-term solution
to the current Medicare payment system.
Anecdotes and feedback can be sent to mnichels@acc.org.
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