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Cardiology Takes Legal Action Against Medicare
Date:12/29/2009

ch Medicare determined the reimbursement rates was deeply flawed. As a result, the 2010 Rule will levy cuts to cardiologist services by up to 40 percent and will deny critical cardiovascular care for millions of heart patients," said Jack Lewin, M.D., CEO of the ACC. "The ACC is committed to stopping these cuts and reversing the 2010 Rule. Over the past decade, there has been a 30 percent reduction in death and disability related to cardiovascular disease. These cuts will significantly roll back these gains. We still remain hopeful that President Obama, Congress or Secretary Sebelius will step forward to halt this rule."

The complaint alleges that the number of PPIS responses used to determine the PFS Rule was too small to be representative and that the survey results were not in compliance with the federal regulations which govern precision standards, transparency and review. The complaint also alleges that the consultant group hired by HHS to analyze comments on the proposed rule noted to HHS that the PPIS data used to determine the PFS cuts were counter to all other widely recognized cost measures. According to the complaint, the consultant group concluded that supplemental survey data provided by specialty physician groups, such as the ACC, was more representative of the true cardiology practice than the PPIS data used to determine the PFS Rule.

According to ACC data, the reimbursement cut will result in three-fourths of the nation's private cardiovascular practices cutting services and eliminating thousands of current staff. There has already been a mass migration of cardiologists from private community practice to direct employment by hospitals, increasing costs and threatening access for millions of patients. As a result of their data, ACC concludes that with fewer cardiology practices and reduced staff, a majority of patients will have no choice but to go to the hospital-based setting to receive routine medical services in addition to
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SOURCE American College of Cardiology
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