Health Reform Bill Passes in the House The U.S. House of Representatives narrowly passed the American Health Care Act (AHCA) on May 4 in a 217 – 213 vote. The legislation, which would repeal and replace provisions under the Affordable Care Act, now moves to the Senate. “The American College of Cardiology opposes the AHCA in its current form, and is disappointed by its passage in the House,” said ACC President Mary Norine Walsh, MD, FACC. “As it stands, the AHCA would allow states to bypass existing federal protections for sick and elderly people, and potentially undermine coverage for critical services for patients with heart disease.” The ACC has previously expressed concerns about elements of the AHCA, particularly its impact on patient access to efficient, high quality care; protection for individuals with pre-existing conditions; and continued national investment in preventive care, medical research and innovations. “This iteration of the AHCA is inconsistent with the ACC’s Principles for Health Reform, which reflect our belief in the importance of promoting patient access to meaningful insurance coverage and quality, cost-effective care,” Walsh said. “It is important for all members of Congress to prioritize protection for the most vulnerable Americans as health reform efforts move forward. The ACC will continue to work with lawmakers on both sides of the aisle to create solutions that maintain patient access to the coverage and care they need.” The Letter is in the Mail The Centers for Medicare and Medicaid Services (CMS) has mailed letters to the clinicians exempt from Merit-Based Incentive Payment System (MIPS) reporting for the 2017 performance year. The letters provide information on whether there are multiple clinicians billing under the same taxpayer identification number and options for reporting MIPS as a group. To qualify for exemption, clinicians must treat a low volume of Medicare beneficiaries or be ineligible to participate in MIPS for 2017, which includes those participating in Medicare for the first time. All letters were expected to hit mailboxes by the first week of May. Contact the QualityNet Help Desk at 1-866-288-8292 or firstname.lastname@example.org with any questions regarding your letter. Visit the ACC’s online MACRA hub at ACC.Org/MACRA for more information and tools related to MACRA. ACC Weighs In On “Healthy” Label In September 2016, the U.S. Food and Drug Administration (FDA) requested comments from the public on the use of the word “healthy” on food packaging. At the request of ACC’s Prevention Section Nutrition Working Group, the ACC weighed in and submitted specific recommendations through a comment letter. The letter recommends that the FDA act to address regulatory deficiencies impacting consumers of packaged foods, including combining ingredient lists, misleading front-of-package nutrient claims and the allowance of confusing descriptors. Additionally, the letter recommends “that the FDA accelerate the important initiative to define ‘healthy’ and other commonly-used descriptors and proactively address potential marketing work-arounds.” Prior Authorization and Patient Access ACC Membership Committee Chair Robert A. Shor, MD, FACC, recently penned an op-ed in the Morning Consult titled, “Prior Authorization: A Major Impediment for Patient Access,” in which he discusses the hurdles created by the burdensome prior authorization process. “While clear strides have been made in affecting meaningful change in this process, much work remains in finding a solution that meets the needs of patients, providers and insurers,” says Shor. “Walking a tightrope is a challenge, but it’s also invigorating to see what you’ve accomplished once you get to the other side. Insurers, health care providers and lawmakers need to work together – one step at a time – to find a solution that at the end of the day saves time, money and, most importantly, lives.” The ACC has developed a prior authorization reporting tool (PART) to collect data on these disputed requests from ACC members. The tool is intended to collect limited information from the pre-authorization requestor on the insurance company, prior authorization vendor, procedure requested, reason for denial and de-identified patient indications. Scan the QR code to access the tool. FDA UPDATES The U.S. Food and Drug Administration (FDA) has issued an update regarding the Class 1 recall for all HeartWare Ventricular Assist Device (HVAD) controllers (Product Codes 1400, 1401, 1403, 1407) manufactured by Medtronic Mechanical Circulatory Support from March 1, 2006 to Dec. 1, 2016. Since the recall was issued in November 2016, Medtronic Mechanical Circulatory Support has developed an updated HVAD controller and power management software to address power connector issues. The new FDA update includes an additional recall of the HVAD DC adapter (Product Code 1435) and instructions to exchange recalled products The update recommends that health care professionals: • Review the notice and forms, and forward the notice to other staff within their organizations for their awareness • Complete, sign, and return the “Acknowledgement Form” to Medtronic Mechanical Circulatory Support within 30 days of receipt of the letter • Complete training that will cover the new product labeling including the instructions for use and patient manual • Quarantine and replace affected HVAD controllers, DC adapters, instructions for use, emergency responder guides and patient manuals in hospital inventory after training is complete • Notify and schedule each of their patients as soon as possible for an appointment to exchange their controllers • Return all quarantined HVAD controllers and DC adapters to Medtronic Mechanical Circulatory Support • Once the affected product in inventory has been identified and returned, complete and return the “Completion Form” to email@example.com or the Medtronic Mechanical Circulatory Support representative no later than 12 months from the date of the letter according to the instructions on the form. CMS Issues New HF Specialty Designation Code After approving a new specialty designation for “Advanced Heart Failure (HF) and Transplant Cardiology” at the end of 2016, the Centers for Medicare and Medicaid Services (CMS) has completed the necessary steps to create the code (C7) and make it available for physicians to use in their provider enrollment. The new code, which will take effect on Oct. 1, will allow CMS to distinguish HF and transplant cardiologists from clinical cardiologists when billing for Medicare services. Previously, no mechanism existed for CMS to accurately identify this category of physician for quality and payment programs. Some local Medicare carriers have denied claims in the past, citing duplicate billing, when a cardiologist and an HF specialist from the same practice have billed for patient evaluation services. HF certification from the American Board of Internal Medicine is not required to use the code. Any provider who selects a specialty code is attesting that they meet Federal and State requirements for the specialty and are “properly staffed, equipped and stocked (as applicable, based on the type of facility or organization, provider or supplier specialty, or the services or items being rendered) to furnish these items or services.” “This is a critical milestone for advanced heart failure and cardiac transplant specialists, validating their critical role and contribution to patient care,” says Biykem Bozkurt, MD, PhD, FACC, chair of both the Heart Failure and Transplant Section Leadership Council and the ACCF/AHA Task Force on Clinical Data Standards. “We urge HF and cardiac transplant cardiologists to contact their administrators and billing staffs to enroll or update their specialty to reflect this new designation within 60 days of the implementation date.” Advocacy in Action in Ohio ACC’s Ohio Chapter held its annual Legislative Day earlier this month, during which 35 Chapter members advocated for medical tort reform, STEP therapy, tobacco tax reform and telemedicine reform. Scan the QR code to see a video interview with Laxmi S. Mehta, MD, FACC, Ohio Chapter president, about the importance of grassroots action. Other interviews from the event are available on the ACC’s Advocacy YouTube playlist. Follow @Cardiology on Twitter for ACC Advocacy updates like these.
Published by American College of Cardiology. View All Articles.
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