The Indiana House of Representatives approved a statewide smoking ban on February 26, 2010. The legislation now moves on to the state Senate. Rep. Charlie Brown, D-Gary, revived the ban and added it to a public health bill. Contact your senator today to encourage passage of Senate Bill 175.

 

The Senate failed to pass legislation on February 26, that would stop the 21.5 percent Medicare physician payment cut. This cut will now take effect March 1. Although the House passed a bill to eliminate the cuts (H.R. 3961) this past November, the Senate has been unsuccessful in passing similar legislation (S. 1776). The Centers for Medicare and Medicaid Services (CMS) are notifying their contractors to hold Medicare physician claims for 10 business days, effective Monday.  
 
ACC members are urged to call your lawmakers immediately, even if you already have, and urge them to work with their colleagues to enact a permanent replacement of the flawed sustainable growth rate (SGR) formula. Call your members of Congress at (800) 210-7193 or contact your Representatives here and your Senators here.
 
In related news, physicians have until March 17 to change their Medicare "participating" or "non-participating" status for 2010. It is unclear whether that deadline will be extended in response to upcoming congressional action. The American Medical Association has updated its guidance document, "Medicare Participation Options for Physicians (PDF)," to address important considerations for physicians when making their 2010 participation decision.

 

The American College of Cardiology is honoring former President James T. Dove, MD, MACC, for his countless contributions to improving the quality of cardiovascular care by endowing a lectureship in his name at the Annual Scientific Session, as well as naming its annual Chapter Recognition Award for Quality the "James T. Dove Chapter Recognition Award for Quality." These recognitions pay tribute to Dr. Dove's outstanding career and his unparalleled commitment to promoting quality improvement. Dr. Dove has influenced generations of cardiovascular professionals and his leadership in quality improvement is legendary.  The Indiana-ACC is making a contribution to the fund. If you would like to give to this special fund, please visit https://services.acc.org/onlinedonations/

The ACC is encouraging insurance providers to consider alternatives to Radiology Benefit Managers (RBM's), and is looking at new types of technology such as methodologies used by Medicalis (www.acc.org/qualityandscience/clinical/auc.htm?Varsite=cc) to ensure patients are receiving appropriate tests. Positioned at the information juncture between ordering physicians, diagnostic service providers and managed care organizations, Medicalis captures and communicates information from the various stakeholders.

Appropriate Use Criteria (AUC) define "when to do" and "how often to do" a given procedure in the context of scientific evidence, the health care environment, the patient's profile and a physician's judgment.  Share your AUC experiences with the FOCUS Community (focus@lists.acc.org).  You can join the Community here: www.acc.org/focus. While we understand that not every member may be able to participate in FOCUS at this time, we do want to make sure you are fully aware of the program and that those who can are involved.

Over the next several weeks, many of you will be receiving email requests to participate in surveys as part of the Relative Value Scale Update Committee (RUC) process. The RUC -- which is a joint effort of the American Medical Association and medical specialty societies like your ACC -- makes recommendations on revising and updating the resource-based relative value scale used by Medicare and many private payers. These surveys ask physicians to evaluate the work of services performed by cardiologists. Information, such as the time it takes a cardiologist to perform certain services for patients, is critical to ensure appropriate valuation. These surveys are sent on a routine basis but a large number of cardiology services are being reviewed as part of this process at this time. The ACC strongly encourages members who receive these surveys to take the time to complete them.

This month, AETNA announced its plans to nationally expand the cardiology pre-authorization program to include outpatient stress echocardiography and diagnostic left heart catheterization beginning in the Spring of 2010.  The American College of Cardiology (ACC) submitted its opposition to the program as well as comments on the MedSolutions clinical guidelines.

Members of the ACC, the American Society of Echocardiography, and Society for Cardiovascular Angiography and Interventions met with medical directors from AETNA and MedSolutions to discuss the cardiology's concerns with the program expansion.  The cardiologists highlighted their difficulty understanding the guidelines and the limited list of appropriate indications for stress echocardiography.  The left heart catheterization section lacked sufficient clinical evidence and literature to support the approved and unapproved indications.  The group also discussed claims that MedSolutions inappropriately denies pre-authorization requests for nuclear cardiology stress tests for based on cost and radiation dosage in favor of stress echocardiography.

Note: ACC requests your assistance in collecting specific de-identified examples of denied appropriate scans by MedSolutions or another RBM.  If you have examples to share, please contact Henry McCants at hmccants@acc.org.