Colleagues,

Lots of stuff goin' on ...

Spring is here, and so are many developments in healthcare, the ACC, and the IN-ACC. 

SGR and ICD-10

Once again, at the eleventh hour, the medical community has had another "stay of execution" as Congress passed a one year "patch" for the Sustainable Growth Rate (SGR), putting off a potential 25 percent cut in all Medicare provider payments.  Although a big relief, Congress' failure to formulate a permanent (i.e. >10 year) solution was particularly bitter given that there was broad bipartisan support for such legislation. The sticking point? How to pay for the approximate $130 billion 10-year price tag.  ACC played a pivotal role in educating and advising lawmakers to get to a consensus regarding content of the proposed, but as of yet, delayed legislation.  Within the current agreement or "patch," and central to the proposed long term bill, is an acknowledgement of using Appropriate Use Criteria developed by professional societies, including ACC, as the agreed future method to approve payments for testing and treatments.  In addition, the bill delays the launch of ICD-10 coding for another year, a welcome relief for many.

The ABIM's MOC Program

In the spirit of "we are not quite ready for that," the ABIM has also decided to extend the deadline for enrollment in the Maintenance of Certification (MOC) program for one more month, to April 30, 2014.  After that time, those who are board certified, including "grandfathers," who are not enrolled in the MOC program will be publically reported on the ABIM's website as "Board Certified, not meeting maintenance of certification" while those enrolled will be listed as "Board Certified, meeting maintenance of certification."  As a reminder, participants must earn 100 MOC points (including 20 MOC Part 4, or Practice Improvement Module [PIM], points) every 5 years.  "Non-grandfathers" must take the secure recertification exam every 10 years. 

There was a very lively presentation and discussion at the ACC Board of Governors' meeting on March 28, 2014, with Dr. Richard Baron, the CEO of the ABIM.  Strong opinions regarding the lack of data to validate the quality impact of the recertification process, concerns regarding its lack of ease of use, and complaints about the high costs, both direct and indirect, were aired by ACC Governors with little "sugar coating."  ACC members admired Dr. Baron's bravery for "facing the music," but left with little confidence that ABIM would acquiesce to the will of the cardiology community.  Although a misconception of many, ACC does not designate Board Certification.  ACC, does, however provide MOC modules and other tools to help achieve the ABIM's MOC goals.  Activities related to submitting to and using the ACC -NCDR database can be used to construct a self-directed PIM to acquire MOC Part 4 points.

CPR Training Legislation

Locally, back home in Indiana, after intense debate, the State House of Representatives and State Senate passed House Bill 1290.  Gov. Mike Pence signed the bill into law on March 31, 2014.  A coalition of interested parties including IN-ACC and the Midwest Affiliate of the AHA supported the bill's provisions to educate high school coaches and athletic trainers regarding risk identification and evaluation of student-athletes potentially exhibiting prodromal signs and symptoms of cardiac arrest/sudden cardiac death.  For IN-ACC, the key component of the bill was a high school graduation requirement for CPR training (including use of AEDs) starting July 1, 2015.  In a compromise to get the bill passed, schools were provided with a waiver process if they truly could not meet this requirement due to limited resources, somewhat "watering down" the legislation.  However, all parties, including the Department of Education who initially opposed the bill, are now interested in refining the law to minimize the impact of any waivers and to expand funding for the program.  This is quite an accomplishment.  Even if 50 percent of all graduating high school students are trained, the potential impact on survival of out of hospital cardiac arrest will be substantial.

Kind regards, 

Edward T.A. Fry, MD, FACC

You're Invited! Indiana-ACC Dinner Meetings

Risk Stratification Post MI for Patients at Risk for Sudden Death

Complimentary Registration.

Wednesday, April 30, 2014 - Bloomington

or

Wednesday, May 7, 2014 - Granger/South Bend

The new ACC College-Wide mentoring program is now live at http://www.cardiosource.org/mentoring thanks to the efforts of the Early Career Professional council, staff, and Health-E-Careers. 

The Indiana-ACC received an ACC Chapter Innovation Award at the ACC Leadership Conference in January! The Indiana-ACC was recognized for

carrying forward the College's digital strategy mission on a Chapter level to increase engagement, decrease cost and enhance member experience at our Annual Meeting by creating a mobile meeting app. Congratulations!

The Indiana-ACC held another great Legislative Day in Indianapolis in collaboration with the American Heart Association on February 11. Attendees began the day with advocacy training. Members then headed to the Statehouse to share information with legislators about legislation impacting CPR training and youth cardiac arrest. In addition, members were able to perform heart healthy screenings on Statehouse staff. It was a fantastic day. Subsequently, House Bill 1290 passed and was signed into law; this legislation will insure that high school students learn CPR prior to graduation.

See photos of the event here. 

Despite a last ditch effort by Senate Finance Committee Chairman Ron Wyden to permanently repeal and replace the Sustainable Growth Rate (SGR) formula, the Senate passed the Protecting Access to Medicare Act of 2014 (H.R. 4302) on March 31 in a vote of 64-35. The legislation, which delays for 12 months a 24 percent Medicare physician payment cut that was set to kick in April 1, is the 17th patch that Congress has enacted since 1997. The House passed the bill by voice vote. It also delays the transition to ICD-10 for one year. Get more details on the provisions included here.