SGR call to action: Without further action from Congress, Medicare physician payment will be cut 27.4 percent on Jan. 1. In addition to the pending SGR cuts, it is important to note that further payment cuts and prior authorization for imaging services were discussed during deficit committee negotiations and could be used to pay for any Medicare bill. Your ACC is asking all members to contact their representatives and senators and urge them to protect patient access to care by enacting a long-term solution to the SGR and opposing further payment cuts to medical imaging. Cardiovascular professionals that provide imaging services need to stress that further payment reductions for imaging services cannot be absorbed by physician practices without impacting access to high quality care. Even if you have already contacted your lawmakers this year, this week is critical for building pressure for the best possible SGR agreement. There are two ways to take action:
- Call the AMA Grassroots Hotline at (800)-833-6354.
- Use the ACC's grassroots advocacy system to send a letter to your respective lawmakers. Be sure to personalize the draft letter.
Creating a RACket ... The last edition of the Advocate reported on the announcement by the Centers for Medicare and Medicaid Services (CMS) of three RAC demonstration projects to be conducted in 11 states, one of which includes prepayment review of inpatient hospital claims. Your ACC is very concerned about the limited information available, as well as the implications of these programs, and has spoken with CMS about these concerns. ACC staff has also emphasized the need for CMS to work with professional societies like the ACC to educate and inform physicians. To date, CMS has not determined which DRGs the RACs will focus on for the prepayment review project, but noted that reviews will be conducted on only a subset of claims. Your ACC will continue to monitor developments on the RAC demonstrations and will advocate for fair treatment of all providers. Stay tuned to the Advocate for more information as it becomes available.
Florida Update: Independent of the newly announced RAC demonstration project, First Coast Service Options (FSCO), the Medicare Administrative Contractor (MAC) for Florida, Puerto Rico and the U.S. Virgin Islands, will begin a program of prepayment review of 100 percent of hospital inpatient claims for 15 cardiovascular and orthopedic DRGs. If, after review of documentation the inpatient claim is denied, FSCO will conduct post-payment review of physician claims related to the admission and may demand repayment. Only providers in Florida are affected. The ACC's Florida Chapter is actively engaged and advocating for members in Florida. Read more about the FSCO project.
Don't miss this "Meaningful" webinar! The ACC's PINNACLE Network is sponsoring a webinar on Thursday, Dec. 15 from 3-4 p.m. ET entitled, "Enhance your Practice and Make Quality Count: Invest in Health IT." Tune in to learn about the evolving role of health information technology within the health care industry and how electronic health records (EHRs) can impact your medical practice. Additionally, the panel will discuss current key issues under consideration for Stage 2 Meaningful Use. Please join Michael Mirro, MD, FACC, Joshua Seidman, PhD, Office of the National Coordinator, Robert Anthony, Centers for Medicare and Medicaid Services, and Janet Wright, MD, FACC, Million Hearts Campaign, for this informative webinar. Register now.
Will You Be Accredited by Jan. 1? All Nuclear Medicine, PET, MRI or CT facilities affected by the CMS deadline for MIPPA are required to be accredited by Jan. 1 in order to qualify for reimbursement. If you have not yet submitted your completed application, your ACC and the Intersocietal Accreditation Commission (IAC) urge you to do so immediately. Although submitting today will not allow the IAC sufficient time to process your application in order to meet the January deadline, it does bring your facility one day closer to achieving your accreditation and ensuring reimbursements.
Questions/Comments contact advocate@acc.org.