"Cardiovascular disease is the number one cause of death and the leading driver of health care costs. We own the problem. We must own the solution." These three sentences clearly articulate ACC's Advocacy mission and were the cornerstone of ACC's first-ever virtual Legislative Conference that took place from Oct. 4 to 6.

Much has changed – and quickly – over the last many months given the COVID-19 pandemic. We continue to adjust our day-to-day personal and professional lives in ways we could not have possibly predicted or imagined.

However, ACC President Athena Poppas, MD, FACC, said it best when she noted in her Welcome Address that the need for advocacy has remained constant.

This need for advocacy is why the Legislative Conference has been arguably more important than ever and also why it was inspiring to have more than 600 clinicians spanning the entire cardiovascular care team, as well as the U.S., take time out of their busy schedules to amplify the voice of the profession and our patients – albeit virtually.

Highlights of the conference included a special HeartPAC keynote featuring political analysts Amy Walter and Charlie Cook, both of whom shared their perspectives on the upcoming November General Election.

An active HeartPAC Twitter Chat also provided a unique opportunity for ACC Advocacy leaders to informally interact and answer questions from Fellows in Training, first-time conference attendees, and others.

An evening education session on Monday walked conference participants through major health policy issues before Congress, provided important regulatory affairs updates, and provided an opportunity for a Q&A with ACC Advocacy Staff.

Board of Governors Chair Dan Philbin, MD, FACC, also provided sage advice to meeting with lawmakers and their staff: "What you are doing tomorrow isn't lobbying, it's educating," he said. "You are the experts here. No one knows more about cardiovascular care and treating patients than you. Be direct. Be memorable."

Attendees took this advice to heart on Tuesday, as they met virtually throughout the day with their respective state delegations advocating to:

• Protect access to telehealth services
• Increase patient access to cardiac rehabilitation services
• Promote clinician well-being
• Decrease administrative burdens
• Provide urgent resource needs and flexibility for medical practices

Specifically, members of Congress were asked to protect patient access and current improvements to telehealth services under Medicare during and beyond the COVID-19 pandemic.

In the House, representatives were asked to co-sponsor the Protecting Access to Post-COVID-19 Telehealth Act of 2020 (H.R. 7663) which would eliminate originating site restrictions, establish a patient's home as an eligible site for telecare, and extend telehealth reimbursement for 90 days beyond the end of the COVID-19 public health emergency.

Members in both the House and Senate were encouraged to further increase patient access to cardiac rehabilitation services by building upon past legislation, specifically the Bipartisan Budget Act of 2018, which included provisions to allow physician assistants, nurse practitioners and clinical nurse specialists to supervise cardiac, intensive cardiac and pulmonary (CR/PR) rehabilitation programs, beginning in 2024.

Legislative Conference participants asked lawmakers to support several specific pieces of legislation, while also asking them to require Centers for Medicare and Medicaid Services (CMS) to allow the temporary provision and reimbursement for telehealth delivered home-based CR/PR services for the duration of COVID-19.

Supporting clinician well-being by providing liability protections during a declared emergency and promoting efforts to foster clinician wellness on the front lines was also an important part of conversations.

In the House, the Coronavirus Provider Protection Act (H.R. 7059) would provide liability protections for clinicians during the pandemic, while the Coronavirus Health Care Worker Wellness Act of 2020 (H.R. 7255) would give grants to establish or expand clinician mental wellness programs.

Additionally, the Dr. Lorna Breen Health Care Provider Protection Act (H.R. 8094) would create behavioral health and well-being programs along with a national campaign to encourage clinicians to seek support and treatment.

Legislative Conference participants also shared their personal stories about burdensome administrative activities like prior authorization that detract from patient care.

Members of the House were asked to co-sponsor the Improving Seniors' Timely Access to Care Act of 2019 (H.R. 3107), which would streamline prior authorization practices and increase transparency and accountability in the Medicare Advantage program, while Senators were asked to consider similar legislation.

The ability for practices and hospitals to remain financially stable and maintain clinical infrastructure and safeguard patient access to cardiovascular care also generated good discussion among clinicians and lawmakers.

Specifically, members of Congress were asked to monitor implementation of 2021 Medicare rules and encourage CMS to waive budget neutrality within the Physician Fee Schedule to avoid particularly damaging cuts amidst the COVID-19 public health emergency.

While the traditional, in-person Legislative Conference would have been ideal, this year's conference just continued to demonstrate the power and innovation of the ACC community and the cardiovascular profession in general.

As Dr. Poppas said: "We have proven over the last several months that we can come together and rise to any occasion no matter what."

And we did!

On behalf of the Health Affairs Committee, HeartPAC, and the ACC Advocacy Team, thank you to all who joined together to help further not only the Advocacy mission, but the College's overall Vision of a world where innovation and knowledge optimize cardiovascular care and outcomes.

We can't do this alone and advocacy plays a critical role in moving us all forward.

Clinical Topics: Cardiovascular Care Team, COVID-19 Hub

Keywords: ACC Publications, Cardiology Magazine, Legislative Conference, COVID-19, Pandemics, Coronavirus, Coronavirus Infections, severe acute respiratory syndrome coronavirus 2, Centers for Medicare and Medicaid Services, U.S., Lobbying, Nurse Clinicians, Prior Authorization, Cardiovascular Diseases, Cardiac Rehabilitation, Cause of Death, Medicaid, Social Media, Telemedicine, ACC Advocacy

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