ACC and SCAI Report on Advocacy Activities

January 11, 2010—The American College of Cardiology (ACC) announced that it is applying all means necessary to turn over the Centers for Medicaid & Medicare Services’ (CMS) 2010 Medicare Payment Rule. On the legal front, the United States District Court in Florida has granted the ACC’s request for an expedited hearing on a motion for a preliminary injunction. This hearing is scheduled for early January, and the ACC is in an expedited discovery phase.

On December 28, 2009, the ACC filed a complaint, as well as motions for a preliminary injunction and expedited discovery, against Health and Human Services Secretary Kathleen Sebelius. The ACC’s Campaign for Patient Access Web site provides daily updates on the legal activities, as well as ACC’s regulatory and legislative efforts. It also provides tools and resources for patients and practices and more information on frequently asked questions. Without a reprieve from Congress or CMS before January 1, the cuts included in the final rule are official. The ACC Web site and the Campaign for Patient Access Web site offer a series of documents to help physicians and practice administrators navigate the biggest changes, including those related to cardiology coding and the new consultation policy, as well as a practice survival tool kit to help with important decisions regarding practice management.

In other advocacy news, the Society for Cardiovascular Angiography and Interventions(SCAI) distributed a letter to legislators on Capitol Hill on January 8, expressing the society's strong reservations about current proposals to penalize hospitals based on high "all-cause" readmission rates after PCI procedures. SCAI stated that it is concerned that patient access to quality care will be limited if Congress mandates financial penalties based on current measures that are untested and unproven.

According to SCAI, although it does support appropriate efforts to measure preventable readmissions and improve quality of care, it is opposed to "all-cause" measures because they will encourage a variety of actions that are not in patients’ best interests, such as:

• Avoiding high-risk patients (eg, congestive heart failure or end-stage renal disease) who are statistically more likely to be readmitted and who may receive the most benefit from interventional therapies
• Delaying treatment for other medical conditions until after the 30-day window has expired, thereby increasing patient risk
• Extending patients’ length of stay in the hospital to avoid readmissions
• Outpatient treatment of initial angioplasty patients who would be more safely treated as inpatients, in order to avoid possible readmission
• Treating patients who return to the hospital postprocedure as outpatients in order to avoid the readmissions
• Intervening on borderline lesions to prevent angina that might lead to readmission.