After months of watching to see how Congress would navigate the so-called "fiscal cliff," the wait is finally over. President Barack Obama signed the American Taxpayer Relief Act of 2012 into law on Wednesday, Jan. 2, one day after the Senate and House of Representatives voted in favor of the bill. While lawmakers failed to solidify an agreement by the Dec. 31 deadline, lengthy negotiations resulted in a bipartisan deal late Tuesday, Jan. 1, averting tax increases and spending cuts from simultaneously going into effect

The final legislation includes a one-year patch of the flawed Sustainable Growth Rate (SGR) formula, preventing Medicare payment cuts of 26.5 percent that were set to kick-in on Jan. 1. Across-the-board cuts of 2 percent were also delayed, keeping Medicare reimbursement safe for another two months. Provisions to qualify registry programs to meet Physician Quality Reporting System (PQRS) reporting requirements and enhance the quality of data needed for new delivery and payment models were also included in the legislation. Your ACC was instrumental in developing both of these provisions in conjunction with other medical associations. Finally, the Geographic Work Adjustment was extended through 2013 and funding for the National Quality Forum was reauthorized for another year. The bill did not include graduate medical education or hospital outpatient department cuts for cardiology.

In response to the quality provisions included in the final legislation, ACC President William Zoghbi, MD, FACC, stated, “We are encouraged to see provisions that were made to qualify clinical registry programs to meet PQRS reporting requirements. Professional society clinical data registries, such as the ACC’s National Cardiovascular Data Registry, collect robust data that are used to provide feedback to physicians and enhance performance. This focus on quality, evidence-based care by itself is an effective way to reduce overall costs while enhancing quality of care. Now that more physicians can meet PQRS requirements, registries will continue to reduce the cost of care and improve quality of life for cardiology patients.”

While the overall outcome of the package is positive for medicine, the offsets used to pay for the $25 billion SGR patch included an increase to the equipment utilization rate for advanced imaging modalities such as CT and MRI, which results in lower payments. Congress has stepped in numerous times over the last decade to temporarily address the SGR and while the current fix staves off the nearly 30 percent cuts for all of 2013, a permanent repeal is essential to restore financial security to physicians nationwide.

The outcome underscores the importance of ACC's Advocacy efforts and grassroots action. Hard work from ACC's Advocacy team helped keep prior authorization and changes to the in-office ancillary services exception out of the agreement. Moving forward it is crucial to keep up the momentum throughout the coming year and the College will continue to urge Congress to enact meaningful health care payment reform that rewards appropriate, patient-centered care. Stay tuned to The ACC Advocate and CardioSource.org for ways you can take action and help lawmakers understand how their decisions impact cardiology.

Keywords: Physicians, Registries, Education, Medical, Graduate, Outpatients, Quality of Life, Medicare, United States

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