On
April 27, 2010, the ACC sent
a letter to CMS urging the
agency
to implement provisions of the Patient Protection and Affordable Care
Act of
2010 (PPACA) in a manner that minimizes the costs and administrative
burdens on
cardiovascular practices. The letter addressed two specific provisions
of
PPACA, both pertaining to amendments to the physician self-referral
(Stark)
law.
Provide list of alternate
service providersThe
first provision is a requirement that physicians referring patients for
computed tomograph (CT), magnetic resonance imaging (MRI), positron
emission
tomography (PET), and potentially other radiology services in which they
have
an ownership or other financial interest provide those patients with a
list of
alternate providers of those services. By law, physicians will need to
provide
a written list of other imaging centers that provide the service in the
area in
which the patient lives. The ACC is urging CMS to compile the lists of
alternate service providers and to create a standardized notice with
information on how physicians should disclose ownership interests and
how lists
of alternate providers are to be compiled. The ACC believes it is
critical that
the list of alternate sources be for the same service for which the
patient has
been referred, and that CMS develop a standardized, consistent method
for
providing accurate information to patients.
Self-disclosure protocolThe
second provision addressed in
the letter pertains to the creation of a
self-disclosure protocol that will allow physicians who determine that
they
have violated the physician self-referral (Stark) law to disclose this
to the
government in exchange for reductions in penalties. This requirement was
added
by Congress to address the stance taken last year by the Office of the
Inspector General that it would only allow for such discussions in cases
where there was also a violation of the federal antikickback
statute. Given that most physicians do not intend to violate the Stark
law
and only do so inadvertently, the College is urging CMS to develop a
disclosure
protocol that provides "leeway for those who have attempted to comply;
believed to a reasonably degree of certainty that they were, in fact, in
compliance;
and reasonably seek to remedy the situation when they determine a
violation has
been committed."
The
concerns raised and recommendations made in the letter were developed in
consultation with the new Council on Clinical Practice and approved by
the
Advocacy Steering Committee.
I am available for you and
welcome your comments and feedback.Please
let me know your thoughts,and
hopefully we can contribute to making a difference.
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