The long-awaited U.S. Supreme Court ruling regarding provisions in the Affordable Care Act (ACA) was released on June 28. In a majority decision, the Court ruled that the ACA, including its individual mandate that virtually all Americans buy health insurance, is constitutional.

"Now that the long-awaited Supreme Court decision on the Affordable Care Act is behind us, we can continue down the path to health care reform," said ACC President William Zoghbi, MD, FACC. "The ACC favors provisions in the law that support preventive care, access to care, elimination of waste, and a payment system that encourages quality. Hard work remains ahead before we arrive at a sustainable payment system that emphasizes value and a strong patient-doctor relationship. The ACC remains committed to quality patient care."

The ACA is the largest expansion of health care coverage since Medicare and Medicaid were initiated in the sixties. The Supreme Court decision means that efforts already underway to implement the law can and will continue. To that end, the ACC will continue to support the policies and provisions with the law that are in line with its overarching health care reform principles, including those that expand health care coverage, encourage preventive care, and foster innovative payment and delivery system models that reward quality and ensure value.

Additional Resources Post-Decision Coverage: The Dénouement of the Supreme Court's ACA Drama (NEJM) Post-Decision Coverage: The Road Ahead for the Affordable Care Act (NEJM) Physician Voice for Health Care Reform: Interview With Bob Kocher ACC in Touch Blog Post Poll: The Supreme Court Ruling and Payment Reform Add Your Comments

At the same time, the College will also continue to work with Congress and the Centers for Medicare and Medicaid Services (CMS) on provisions that affect cardiovascular care. Among those:

• Implementation of the controversial Independent Payment Advisory Board, a 15-member Board tasked with developing and presenting proposals to the president and Congress, starting in 2014, to extend the solvency of Medicare, slow cost growth, improve quality of care, and reduce national health expenditures. The ACC remains concerned by the authority granted to an independent body to determine payment cuts for only physicians, particularly in light of ongoing payment reductions as a result of the Medicare physician payment formula.
• Implementation of the Physician Payments Sunshine Act requiring that industry disclose payments to physicians and teaching hospitals, both direct and indirect. While the ACC supports the overarching objectives of the Act, the College has raised concerns regarding CMS’s interpretation and proposed implementation of the Act. Final regulations are expected in the coming months.

The ACC will also continue to advocate for overarching payment and medical liability reforms that were not included in the ACA, but critical for overarching health reform to be truly effective. In addition, the College is focused on several regulatory proposals and legislative efforts expected in the coming months that will have major impacts on cardiology though not directly associated with the ACA. Among them:

• The 2013 Medicare Physician Fee Schedule (the proposed rule is expected as early as this week);
• Additional cardiovascular coding changes as a result of continued bundling efforts;
• The annual battle to repeal/stop the flawed sustainable growth rate (SGR) formula used to calculate Medicare physician payment; and
• Looming physician penalties for non-participation in federal incentive programs like e-prescribing, EHR and the Physician Quality Reporting System.

The ACC is actively engaged in communications with CMS, lawmakers, industry and other stakeholders as appropriate on all of these issues. Stay tuned to CardioSource and The ACC Advocate, and follow ACC Advocacy on Twitter (@Cardiology) for the latest news.

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