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ACC Advocate

Promoting Strong Practices, Protecting Patient Access

Current Issue - December 18, 2014

Lame Duck Ends Current Congress: Last week, the 113th Congress wrapped up their year by pushing through several pieces of legislation before a new Congress takes over in the New Year. Here are a few noteworthy items for cardiology:
  • Cromnibus: the House and Senate passed the "cromnibus" (continuing resolution and omnibus) which will fund most of the government through September 2015. The explanatory statement accompanying the cromnibus includes language suggesting $4 million for surveillance of congenital heart defects at the Centers for Disease Control and Prevention and $4 million for the Department of Health and Human Services' Million Hearts initiative. Explanatory statements do not have the force of law; rather they express the intent of Congress and are meant to guide federal agencies as they budget their appropriated funds.
  • SGR, CHIP, GME Top 2015 Agenda: Congress was not able to pass legislation for a long term fix to the Sustainable Growth Rate (SGR) or to extend funding for the Children's Health Insurance Program, which will be high priorities for next year. Medicare program integrity also promises to be at the top of the legislative agenda. Legislation on federal funding of graduate medical education is expected to be introduced as well.
  • ABLE Act: The House and Senate also passed the Achieving a Better Life Experience Act (ABLE Act). The ABLE Act (H.R. 647/S. 313) will make tax-free savings accounts available to individuals with disabilities to cover qualified expenses such as education, housing and transportation. Unfortunately, the cost of the ABLE Act will be partially offset by amending the current statute pertaining to misvalued codes in the physician fee schedule, which was put into place by the March 2014 SGR patch. Despite firm opposition to the use of that offset from the ACC, American Medical Association and other medical groups, the bill received strong support in Congress and passage was a near-certainty.
  • ICD-10: While there is some pressure to delay ICD-10, many in Congress and at the agencies have warned that ICD-10 will be implemented in 2015 and that all entities should be prepared.
  • 90-Day Global Period: Efforts to include changes to the 90-day global period in the cromnibus were unsuccessful. Many members of Congress expressed support for eliminating the change and are expected to continue exploring remedies in the coming year. Ultimately, language on the global period issue was included in the explanatory statement accompanying the cromnibus legislation.

Avoid 2016 PQRS Payment Adjustments: Eligible providers (EPs) who successfully participate in the 2014 Physician Quality Reporting System (PQRS) will avoid a 2 percent payment adjustment on Medicare Part B fee-for-service payments in 2016. This year marked the final reporting year in which EPs who successfully participate in PQRS will be eligible for a 0.5 percent bonus payment. 2014 PQRS participation will also be applied to the 2016 Value-Based Modifier program, which carries up to an additional 2 percent bonus or penalty based on group size and cost/quality data. Learn more about 2014 PQRS participation. Practices currently submitting data to the PINNACLE Registry can successfully participate in PQRS via the Qualified Clinical Data Registry method. If you want the PINNACLE Registry to report to PQRS on your behalf for 2014, you must submit your electronic data release consent forms no later than Dec. 22. If you have any questions regarding PQRS or your PQRS status in PINNACLE, please contact the PINNACLE Registry Team at 800-257-4737 or ncdr@acc.org.

Don't Forget to Review Sunshine Data: In September, the Centers for Medicare and Medicaid Services (CMS) published the first set of reports for payments industry made to physicians and teaching hospitals from Aug. 1 through Dec. 31, 2013, as part of the Physician Payments Sunshine Act. Physicians are encouraged to review their 2013 data before the end of the year to ensure that the information is correct. Any disputes must be filed by Dec. 31 in order for corrections to be made in the next data release. Learn more about the Sunshine Act.

ACC Pushes for Reduction in EHR Program Reporting Period: This week, your ACC sent a letterPDF urging CMS and the Office of the National Coordinator for Health Information Technology to reduce the 2015 reporting period for the federal Electronic Health Records (EHR) Incentive Program from one year to 90 days. Given the difficulties cardiologists and others have experienced obtaining EHRs that are certified to meet the 2014 standards and certification criteria, the College is concerned that significant numbers will be unable to meet the requirements for the program in 2015. Physicians and hospitals who do not meet the requirements in 2015 will not only be ineligible for any incentive payments, but they will also face penalties in 2016 or 2017, depending on when they started participating in the program.

Reflecting on 2014 Successes: This year, the voice of cardiology was heard loud and clear by lawmakers thanks to ACC's grassroots efforts and ACC Political Action Committee (ACCPAC). In 2014, the ACC connected a record number of members with Congress. During nearly 300 congressional meetings that took place as part of Legislative Conference, ACC members shared examples of how the College is leading the transformation of care. Additionally, ACC members have participated in 68 legislator practice visits and in-district meetings and 20 in-district fundraisers. More than 600 ACC members are connecting with their members of Congress through the ACC Advocacy Action mobile app, which launched earlier this year. On the state level, ACC chapter members in four states teamed with patients to meet with lawmakers and before legislative committees, and four state Lobby Days were instrumental in advancing legislation. With about $930,000 in contributions to date, ACCPAC is pushing hard to surpass $1 million for the 2013-2014 cycle. During Legislative Conference, 300 ACC members supported ACCPAC by attending a special reception and dinner with political power couple Mary Matalin and James Carville. For more information or to contribute to ACCPAC, contact Kendra Adams at kadams@acc.org.

Advocacy in Action: Recently, two ACC members hosted an Energy and Commerce Committee member and a Senate staffer at their practices to show them the ropes of medicine and discuss issues they are facing. Andrew J. Kaplan, MD, FACC, and Sen. Jeff Flake's (R-AZ) district representative Michael Nelson discussed a wide array of issues related to health care in Arizona during a practice visit. Hot topics included payment parity for procedures performed in the office setting compared to hospitals, Stark laws, guidelines, Food and Drug Administration approval, the Sunshine Act and more. During another legislator practice visit, Susan I. Farkas, MD, FACC, met with Rep. Kevin Cramer (R-ND) who will be on the House Energy and Commerce Committee starting in January. It will be crucial to ramp up grassroots efforts such as these in the New Year in order to educate the new Congress. To set up a legislator practice visit, contact Elizabeth Shaw at eshaw@acc.org.

Save the Date: The Pediatric Congenital Heart Association and The Adult Congenital Heart Association are collaborating to provide an essential opportunity to unite the congenital heart community and inform policy in Washington, DC, next year. During the Congenital Heart Legislative Conference, held Feb. 25 – 26, 2015, at the Hyatt Regency in Washington, DC, grassroots advocates will be engaged and will receive targeted education about congenital heart disease research and data collection for legislators. The power of the patient story is magnified through the unique partnership between patients, parents and providers. Learn more.