Report from the Chair of the Board of GovernorsSeptember 25, 2009"The best way to predict the future is to invent it." Allan Kay
Dear Colleagues,
In a major victory for patient-centered in-office imaging, the amendment by Reps. Anthony Weiner (D-N.Y.) and Bruce Braley (D-Iowa), to eliminate the ability of physicians to provide advanced diagnostic imaging services in their offices beginning in 2013, was withdrawn on September 23rd.
The House Committee on Energy and Commerce was considering several amendments to its health reform bill (H.R. 3200) that were left pending just before the August congressional recess. Committee Rep. Weiner (D-NY) offered and ultimately withdrew the amendment on behalf of himself and that of his colleague Rep. Braley (D-IA). The amendment excluded certain advanced diagnostic imaging services from the in-office ancillary services exception to the prohibition on physician self-referral. Rep. Weiner decided to withdraw the amendment on the premise that he would “continue to work on the issue further” with the commitment of the Chairman, Congressman Henry Waxman (D-CA). Both congressmen spoke about the problems associated with financial conflicts of interest as well as the safety and quality concerns that they felt were inherent with physician ownership of imaging equipment. Representative Weiner made a statement about the detrimental effects associated with physician self-referral. Representative Braley reiterated Representative Weiner’s remarks and further highlighted the dangers of radiation in the hands of untrained providers. Representative Weiner added that he would like for CMS to examine the issue of physician self-referral and determine any possible regulatory solutions through the tightening of existing regulations.
The ACC has consistently supported mandatory imaging laboratory accreditation to improve the quality and safety of office-based imaging. ACC staff and leaders continue to meet regularly with members of Congress about the benefits of appropriate use criteria and clinical guidelines to ensure that the right tests are delivered at the right time to the right patients. The ACC has also encouraged the use of accreditation as a tool in quality improvement. Currently the College advocates for mandatory accreditation on many levels including federal, state, and private payers. Almost two years ago, the ACC and other provider groups helped craft language in Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) to require lab accreditation for advanced imaging testing (CT, MR, PET, Nuclear) beginning in 2012. The ACC continues to advocate for mandatory accreditation in state legislatures as well as private payers. The ACC will continue to work with the Intersocietal Accreditation Commission to educate payers on the IAC’s capabilities. After talks with numerous health plans, the IAC is also researching the possibility of including appropriateness to its accreditations which could improve its appeal for payers. I wish to extend special thanks to entire Board of Governors and all of the ACC members who contacted their representatives on the Energy and Commerce Committee asking them to oppose this amendment. Stay tuned for more updates on the broader House health reform bill.
On the Senate front, the Finance Committee this week began its long-anticipated markup of its health care reform bill ("America's Healthy Future Act of 2009"). The bill, drafted by Committee Chair Max Baucus (D-MT), attempts to expand coverage and strengthen Medicare. However, the College has concerns with several of the provisions, including a mere one-year band-aid to the sustainable growth rate (SGR) formula used to calculate Medicare physician payment rather than a permanent fix, as included in the House bill. To view the ACC's letter to Sen. Baucus regarding his bill, go to: http://qualityfirst.acc.org/advocacy/Documents/ACC-to-SenBaucus092009.pdf
In general, the ACC stands ready to support congressional efforts to reform the health care system and is urging leaders in both the House and Senate to act this year on real health care reform that:
- Ensures access to affordable health care for all Americans;
- Includes delivery and payment system reforms that provide incentives for improvement of quality and outcomes;
- Repeals the SGR formula;
- Emphasizes professionalism and patient-centered care;
- Improves care coordination across sources and sites through interoperable health information technology;
- Implements medical liability reforms that reduce legal and defensive medicine costs; and
- Promotes comparative effectiveness research to better inform guidelines, performance measures and appropriate use criteria.
As always, you can get more information on ACC’s health care reform efforts at: http://qualityfirst.acc.org. I also encourage you to share your thoughts on the health reform bills and related issues on ACC's blog at: http://lewinreport.acc.org. Updates on the 2009 Legislative Conference, as well as a guest posts from George Rodgers on the workforce shortage are also among the recent postings. Do not hesitate to e-mail me at: john.harold@cshs.org for any questions or concerns.
JOHN GORDON HAROLD, MD, FACC
Chair, Board of Governors
2009-2010 Board of Governors Steering Committee Membership:
John Gordon Harold, MD, FACC (Chair), California:
john.harold@cshs.orgJane E. Schauer, MD, PhD, FACC (Past Chair), New Mexico:
janeschauer1@msn.comRichard J. Kovacs, MD, FACC (Chair-Elect), Indiana:
rikovacs@iupui.eduJ. Chris Higgins, MD, FACC, Vermont:
jch6@mac.com Oscar R. Jenkins, Jr, MD, FACC, North Carolina:
oscarj@avlcard.comMargo Minissian, ACNP-BC, MSN, CNS, California:
Margo.Minissian@cshs.orgJosé Rivera Del Río, MD, FACC, Puerto Rico:
joseriveradelrio@gmail.comThad F. Waites, MD, FACC, Mississippi:
twaites@netdoor.comMichael Widmer, MD, FACC, Oregon:
michael@heartdoctorsnw.com
Action ItemsDeadline: 10/5: BOG Steering Committee: If you have any items that you wish to bring up next month before BOG Steering for discussion or for informational purposes, please contact Jayne Jordan at
jjordan@acc.org. In addition, if you'd like to present to the BOG-SC a "Report from the Front", a report on the work environment, legislative climate or any other issues in your state, also contact Jayne Jordan.
Deadline, 10/2: NCDR Open Comment Period: The National Cardiovascular Data Registry™ (NCDR™) is providing an open comment period on the proposed executive summary metrics and report components for the CathPCI Registry® version 4.0 Institutional Outcomes Report.
To download and review a sample report and submit comments, please click
http://www.surveymonkey.com/s.aspx?sm=KDsY79_2bsBmHPHTqXL_2bGPsA_3d_3dYour comments must be submitted by 3:00 pm ET, October 2, 2009. Contact: Susan Fitzgerald,
sfitzger@acc.orgDeadline 10/31: Call for Committee Nominations and Applications: If you would like to participate in one of the College’s committees and councils, now is the time to let us know. All College Fellows, Fellows in Training and Cardiac Care Associates are encouraged to nominate and/or apply. Applications are due October 31, 2009. Applicants will be selected by the ACC President-Elect, Ralph G. Brindis, MD, MPH, FACC, this fall and notified of their selection in January 2010.
To view the list of committees will openings and to nominate and/or apply, please login at the Member Center,
http://members.acc.org , on ACC’s website.
Applicants will be asked to list professional experience and practices outside of ACC, honors, and awards, most important publications and any experience and qualifications that my qualify them for a requested committee. All applicants are required to submit a letter of reference from an ACC member. Contact: Marthea Wilson, 202-375-6230 or
volunteers@acc.org
Informational ItemsFred Bove's Sept Monthly Briefing
Please click on the above to read Dr. Alfred Bove's Monthly Briefing to leadership for September 2009.
2010 Calendar:January 29-30 - BOG/Leadership Forum, Park Hyatt, Washington, DC (Details to follow)
March 12-15 - BOG Events at ACC.10, Atlanta, GA
September 12 - 14 - BOG/Legislative Conference, Washington, DC (Details to follow)