In This Issue
Spring Summit
Complete the Survey
NCDR Workshop
Pre-Authorization Program
FOCUS
Ohio-ACC
Spring Summit:
April 21, 2010
The Ritz-Carlton
Cleveland, OH

Dr. David Holmes
Dr. David R. Holmes, Jr. Guest Lecturer

Join us for the 3rd Annual CCA Cardiovascular Update & 47th Annual Carl J. Wiggers Memorial Lecture: What Interventional Cardiology Has Taught Us about Physiology and Pathophysiology.

Get complete information and register today.
 
Not to Be Missed

Contact Us

www.ohioacc.org
[email protected]
614.859.2223
800.983.OHIO

Ohio-ACC News                     March 2, 2010
Robert E. Hobbs, MD, FACCPresident's Message
Robert E. Hobbs, MD, FACC

Take Action
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 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. 
 
Ohio Cardiology Day at the Capitol
I invite you to join us as we go to the Ohio Statehouse on April 27, to meet with our legislators about important issues impacting the practice of cardiology in Ohio. Learn more and register to attend.
Complete the Survey 
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.
Ohio-ACC Hands-on Skills Workshop for the National Cardiovascular Data Registry™ CathPCI Registry® 
Make plans to attend the Ohio-ACC's Hands-on Skills Workshop for the NCDR™ CathPCI Registry® on Friday, May 14, 2010. This conference will help you gain understanding and competence surrounding the data definitions and is featuring a special guest, Tony Hermann, RN, MBA, CPHQ, Associate Director, CathPCI Registry®, American College of Cardiology. Tony has been very instrumental in developing the next generation of the CathPCI Registry®.
 
The NCDR™ has many tools available on its website to assist with the implementation and management of the registry. These tools provide a great starting point, yet inconsistencies remain on interpretation and application of criteria during the data abstraction process. The goal of this workshop is to clarify these inconsistencies, providing a clear understanding of the registry and elements that are far too frequently misinterpreted. Get complete details.
Cardiology Groups Discuss Pre-authorization Program with AETNA and MedSolutions
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 [email protected].  
New Year, Imaging and Appropriate Use Criteria in FOCUS
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 ([email protected]).  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.