Colleagues,

I wanted to share with you the latest report from Dr. John Harold, the chair of the ACC Board of Governors.

Defining Meaningful Use
Over the last year, the ACC has been working with the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC) to provide feedback on what constitutes "meaningful use." Specifically, the College has cautioned against defining meaningful use in a way that creates additional barriers to EHR adoption. Both CMS and ONC are responsible for determining how the program will function.
 
Recently, CMS released a long-awaited proposed rule outlining the agency's vision for the new EHR incentive program and providing the structure for the both the Medicare and Medicaid programs. Specifically, the proposed rule outlines the initial criteria eligible parties must meet to qualify for an incentive payment, when the payments will begin, and how the payments will be calculated.
 
CMS has provided a 60-day public comment period for this rule, as well as for a closely related interim final rule issued at the same time by the ONC. The interim final rule defines the initial standards, implementation specifications and certification criteria for EHRs. It also sets forth the capability requirements for EHRs, another key component of the program. ONC will also be issuing a notice of proposed rulemaking on the process for organizations to conduct the certification of EHR technology in the near future. 
 
The ACC is in the process of analyzing the rules and their potential effects for cardiology and will be submitting formal comments on both. While this is a huge opportunity to advance health information technology, defining "meaningful use" is a huge effort, and CMS and the ONC have a lot of work ahead of them to make this actually palatable to providers. I will keep you updated as the formal comments are developed.
 
Update on Health Care Reform
Health care reform is back in the spotlight, especially given Scott Brown's victory in the race to fill Sen. Ted Kennedy's Senate seat. Brown has pledged to oppose the health care package. As House and Senate members attempt to reconcile the two bills passed before the holidays, the College sent a letter this week to Senate Majority Leader Harry Reid (D-NV) and House Speaker Nancy Pelosi (D-CA) outlining certain provisions of the bills affecting the practice of cardiology. Read the complete letter here.
 
Specifically the letter highlights provisions in the bills that the College supports, including those that would ensure quality of care, address medical liability reform and expand coverage to the nearly 50 million uninsured and underinsured. It also raises some real concerns with several policies, including the lack of a permanent SGR fix and an increase in the imaging equipment use rate for advanced imaging. The College also opposes bans on specialty hospital facilities, penalties for unsuccessful PQRI participation and the current Independent Payment Advisory Board (IPAB) concept.

Action Requested
Please contact your representatives and senators with two specific asks.
1) Urge them to oppose the inclusion of medical imaging payment cuts in health reform.
2) Ask them to include H.R. 3961, "The Medicare Physician Payment Reform Act of 2009," in final health reform legislation. H.R. 3961 would permanently repeal the SGR. Go here to contact your legislators using the easy online system; it will take you 30 seconds.