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ACC Advocate

Promoting Strong Practices, Protecting Patient Access

Current Issue - October 16, 2014

Avoid PQRS Penalty: Physicians who do not report to the Physician Quality Reporting System (PQRS) in 2014 will receive a 2 percent penalty on all 2016 allowable charges. Avoid the penalty by reporting through the ACC's PQRSwizard, an easy to use online tool to help you quickly and easily participate in the program. Similar to online tax preparation software, the wizard guides you through a few easy steps to rapidly collect, validate and submit your results to the Centers for Medicare and Medicaid Services (CMS). You can select from the Heart Failure or Coronary Artery Disease Measures Group options to report on 20 of your patients seen in 2014, 11 of which must be Medicare Part B Fee-for-Service patients. The price per individual professional is $249. Groups of 10 or more providers are eligible for a group discount. Visit CardioSource.org for more information on navigating PQRS.

Lookout for AMA RUC Surveys: In the next few weeks, the ACC and other societies will randomly distribute an American Medical Association (AMA) Relative Value Scale Update Committee (RUC) survey of the myocardial perfusion imaging codes 78451, 78452, 78453 and 78454 and for pacemaker and implantable cardioverter defibrillator programming codes 93279, 93280, 93281, 93282, 93283 and 93284. These services are utilized widely by some ACC members and we need your assistance to ensure the relative value units are accurately and fairly presented to CMS. We need your input since CMS relies on the recommendations from specialty societies and the RUC as a basis for setting payment levels for physician services. The more data we receive, the more compelling our recommendations will be to the RUC and ultimately to Medicare. If you are randomly selected and receive a survey, please take time to complete it. Survey distribution and collection will start in late October and complete in mid-November. The information you provide in this AMA survey will be kept confidential by the ACC. The e-mail will come from noreply@qemailserver.com so please add this address to your e-mail client so that the message does not end up in junk or spam.

Federal Readmission Penalties Kick in: To address the growing burden of hospital readmissions, the Affordable Care Act initiated penalties for poor performing hospitals with Medicare reimbursement cuts starting in 2012. On Oct. 1, when the 2015 Inpatient Prospective Payment System went into effect, CMS reduced payments for 2,610 hospitals by as much as 3 percent due to their excessive readmission rates for patients with heart failure, acute myocardial infarction, pneumonia, chronic obstructive pulmonary disease, and elective total hip arthroplasty and total knee arthroplasty. The penalized hospitals account for nearly 75 percent of facilities subject to payment reductions, and CMS expects the fines to reach $428 million over the course of the year. The ACC's Hospital to Home (H2H) initiative helps hospitals and cardiovascular care providers reduce cardiovascular-related hospital readmissions, improve transitions of care and reduce the risk of federal penalties associated with high readmission rates. If your hospital is participating in the NCDR, you have access to H2H and other quality improvement initiatives and tools. Activate your individual account.

Cardiovascular CPT Coding Update for 2015: In just a couple of weeks, the final 2015 Medicare Physician Fee Schedule, which lays out payment rates and related policies for services performed throughout the year, will be released by CMS. This rule will finalize several changes to cardiovascular coding. Will you be prepared for coding in 2015? Join your ACC on Nov. 12 at 4 p.m. ET for a webinar on CPT coding changes for cardiology in 2015. The chair of the ACC's Coding Task Force will cover the new changes that will impact health care providers in their practice. The webinar will also review the values for each new code. Register now. Stay ahead of the coding curve! Order your copy of the 2015 CPT® Reference Guide for Cardiovascular Coding to ensure you navigate the changes correctly.

Mississippi Makes 41! On Oct. 8, Mississippi passed a regulation requiring all hospitals in the state to perform newborn screening for critical congenital heart defects (CCHD) and report the results to the Department of Health. Significant strides have been made this year on the state level for advancing CCHD screening legislation. Now, 41 states have CCHD screening requirements in place and two others are working on regulations.

FDA Update: The Food and Drug Administration's (FDA) Circulatory System Device Panel met on Oct. 8 for the third time to discuss Boston Scientific's application for approval of the WATCHMAN device, a left atrial appendage closure device. The panel voted six to five with one abstention that the benefits outweighed the risks of the device for the specified patient population, a far closer vote than those of previous panels. The close nature of the vote reflected the panel's concerns regarding the proposed label indication. Discussion throughout the day conveyed panel members' concerns that this be an option only as a second-line therapy for a select group of patients and the need to include this as part of the label indication. Other concerns included the need for sufficient patient education regarding the benefits and risks of the WATCHMAN device, as well as the sufficiency of the proposed post approval study should the device be approved.

EHR Hardship Exception Deadline: CMS is reopening the submission period for hardship applications for eligible professionals and eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of Certified Electronic Health Record Technology (CEHRT). The deadline for submitting applicationsPDF is now Nov. 30, 2014, for both EPs and hospitals, as opposed to the original deadlines of April 1, 2014, for hospitals and July 1, 2014, for EPs. The hardship exception only applies to hospitals and EPs that have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; and EPs who were unable to attest by Oct. 1, 2014, and eligible hospitals that were unable to attest by July 1, 2014, using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule. CMS plans to address this issue in upcoming rulemaking.

Get up-to-speed on ICD-10: CMS has released the 2015 ICD-10-CM Official Guidelines for Coding and ReportingPDF. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. Will your practice be ready for the transition to ICD-10 on Oct. 1, 2015? Review a recent webinar and the ICD-10 resources page on CardioSource.org to prepare your practice.