Breaking news on Accountable Care Organizations (ACOs) released today. CMS just issued its final rule on ACOs, which may make it easier for doctors and hospitals to participate by allowing more flexibility in the design and governance of the ACO; allowing ACOs to participate without taking on downside risk; and allowing patients to be assigned to ACOs based on specialist visits. Your ACC supported many facets of the proposed rule that was released earlier this year but expressed concerns that the requirement for ACOs to take on financial risk would make it difficult if not impossible for physicians, together with hospitals, to form an accountable care organization. We are supportive of the focus on quality of care and the particular focus on cardiovascular care within this final rule. Moving forward, the ACC feels that there must be continued flexibility for physicians and other providers to improve care and we look forward to being strong partners in the efforts to improve quality and reduce costs.
Don't ignore RUC surveys! Annual updates to the physician work relative values are based on recommendations from a committee involving the AMA and national medical specialty societies--the RUC. The RUC is an expert panel of the AMA and specialty societies charged with developing relative value recommendations to Medicare. A key part of the RUC process is the completion of relative value surveys. Data from these surveys are used to establish the physician work that determines Medicare reimbursement. This November surveys will be distributed related to percutaneous coronary intervention, ablation, and extremity artery/vein ultrasound. If you are randomly selected and receive a survey, please take 15-20 minutes to thoughtfully complete it. Contact James Vavricek at 202-375-6421 or jvavricek@acc.org if you have questions or would like to receive a survey.
Action needed: Rep. Michael Burgess, MD (R-TX) and Rep. Gene Green (D-TX) are asking their House colleagues to join a letter to the Medicare Payment Advisory Commission (MedPAC) opposing MedPAC's recent recommendations to replace the flawed sustainable growth rate (SGR) Medicare physician payment formula. As reported recently, MedPAC recommends replacing the SGR with a Medicare payment model that would freeze payments to primary care physicians over the next 10 years while reducing payments to all other physicians by 5.9 percent per year between 2012 and 2014. These cuts would be followed by a seven-year freeze in Medicare payments to these other physician specialties. The ACC strongly opposes MedPAC's SGR plan. Contact your Representative today and encourage him or her to sign the Burgess/Green letter to MEDPAC on the SGR. To sign the letter, your Representative should contact James Paluskiewicz in Rep. Burgess' office at James.Paluskiewicz@mail.house.gov or (202) 225-7772.
Calling all Medicare providers! Under the new risk screening criteria required by the Affordable Care Act, Medicare contractors will be alerting providers enrolled in the Medicare program regarding revalidation of their enrollment. The revalidation process has four steps. Upon notification, providers will need to: 1) update enrollment through the online Provider Enrollment, Chain and Ownership System (PECOS) or complete the 855; 2) sign the certification statement on the application; 3) pay any fees through pay.gov; and 4) mail supporting documents and certification statement to their contractor. To help providers better understand and prepare for this process, the Centers for Medicare and Medicaid Services is holding a national provider call on Thursday, Oct. 27 from 12:30-2 pm (ET). To register for the call, click here. You can also review the Medicare Learning Network's fact sheet for more information.
Nov. 1 e-prescribing hardship deadline is approaching! Eligible professionals and group practices that did not participate in the Medicare Electronic Prescribing (eRx) Incentive Program must request a hardship exemption by this date in order to avoid the 2012 e-prescribing penalty. More information on the available hardship exemptions is posted on the CMS website and CardioSource.org.
Speaking of deadlines... as of Jan 1, 2012, physicians who furnish the technical component of Advanced Diagnostic Imaging (ADI) must be accredited in order to bill Medicare for these services. For dates of service on or after Jan. 1, Medicare contractors will begin denying claims by non-accredited providers. More information about Accreditation process, including a list of accrediting organizations and details of the accreditation process, is available on the CMS website and on CardioSource.org. Also, as of Jan. 2012, providers must be transitioned to Version 5010. There are certain steps that providers should be taking this fall to ensure a smooth transition. Specifically, providers should be continuing with external testing and making any system revisions. Daily transactions, such as claims and eligibility determinations, should be undergoing testing as well. More information on the transition is available on the CMS website and on CardioSource.org.
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