Current news Practice Revenue: Are You Missing Opportunities? RIMS and the MA/RI MGMA welcome nationally-known practice management analyst Frank D. Cohen, MPA. Learn how to analyze your payer mix and design a fee schedule to optimize returns, among other topics. Eligible for ACMPE credits. March 28, 8am-noon Open Q&A after lunch Radisson Hotel 2081 Post Road Warwick, RI For more information contact Sarah Stevens at RIMS at 401-331-3207 Chapter Elections February 2008 Dear RI Chapter ACC Member: In accordance with the Rhode Island Chapter of the American College of Cardiology Chapter’s bylaws it is time to hold council elections in the Central (Miriam Hospital, Rhode Island Hospital, Roger Williams Medical Center and Veterans Administration Medical Center) and Northern (Landmark Hospital, Our Lady of Fatima Hospital and Pawtucket Memorial Hospital) districts. We are accepting nominations from members to fill the following seats which will expire: Northern: Thomas Noonan, MD, FACC Joseph Mazza, MD, FACC Central: David Fortunato, MD, FACC Marilyn Weigner, MD, FACC If you have any questions, please feel free to contact me. Sincerely, Steven R. Fera, MD, FACC Steven R. Fera, MD, FACC RI ACC Chapter President ACC Governor for Rhode Island ACC RI Chapter Governor’s Update February 18, 2008 Medicare Payment Reform This year continues to pose many challenges to the cardiology community. All of us were disappointed that Congress offered only a temporary solution to Medicare physician payment reform and that a permanent one may not be achievable before the next administration takes office. A 10% Medicare cut is scheduled for July if further legislative action does not occur. The upcoming President's Day Congressional Recess (Feb. 15-25) is a critical opportunity to reach out to members of the Senate and impress on them the importance of meeting their self-imposed deadline of July 1 for preventing cuts to Medicare that will endanger the access to care of millions of beneficiaries. The ACC urges all members to contact their Senators and urge them to: • stop the payment cuts for 18 months; • provide a positive update through 2009 that covers the increase in the cost of care; • work to provide a permanent replacement of the physician update formula; • oppose cuts to medical imaging services and support policies that foster imaging appropriateness and quality. Go to www.acc.org/can to take action or call the ACC’s toll free grassroots hotline at 800-210-7193 Provider 2% Tax Locally, the RI Medical Society has made some progress in their campaign against the recently imposed Provider Tax. At a follow-up meeting of interested stakeholders on January 23, Steve DeToy announced that over $74,000 has been raised to date by RIMS members. The Medical Society is concurrently pursuing both judicial and legislative remedies. Firstly, seven representative medical practices have volunteered to serve as plaintiffs in RIMS’ legal case against the state. These cases will be consolidated into a single test case for filing RIMS’ lawsuit. Efforts are also underway to seek legislative repeal of the surcharge through the General Assembly. RIMS President, Dr. Tsiongas, addressed the implications of the tax in a commentary which appeared in 26 daily and weekly newspapers throughout the state. Finally, the Tax Division recently indicated that revenues collected from the tax so far fall well below the state’s budget projections. BCBSRI Prior Authorization for Imaging This initiative was rolled out early this year despite strong resistance from the medical community. Dr Peter Tilkemeier and I met with officials from BCBSRI and MedSolutions in December and succeeded only in delaying the commencement date for the process which enabled practices additional time to plan for implementation. For cardiologists, the online process has generally been very efficient for obtaining cardiac nuclear study authorizations. It appears this process is more cumbersome and time consuming for primary care providers. Recently, BCBSRI made some concessions when it announced that, effective April 1st, it would permit radiologists to initiate preauthorizations. RIMS plans to continue to monitor the preauthorization program and provide feedback to BCBSRI and to the Office of the Health Insurance Commissioner in hope of further reducing potential delays in access to care and patient inconvenience. United Health Care Pilot Program The ACC has announced a pilot program, sponsored in part by UnitedHealthcare, to assist physicians in the appropriate use of Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging (SPECT MPI). The ACC, along with the American Society of Nuclear Cardiology (ASNC), published Appropriateness Criteria for SPECT imaging in 2005, which provide expert physician opinion on the use of diagnostic and therapeutic procedures with regard to cardiovascular disease. The ACC is focusing on assisting physicians in the implementation of the Criteria, which are aimed at improving appropriate test ordering. This program is the first in which the ACC has partnered with a health plan to implement Appropriateness Criteria. The program is a test case of an alternative to health plan pre-authorization procedures and aimed at increasing quality while alleviating the administrative burden of such programs for these practices. The pilot program, to be launched at 10 practice sites, is d esigned to help physicians evaluate their test ordering practices in the context of the SPECT MPI appropriateness criteria. Echocardiographpy not included in final rule "In a major victory for cardiology, CMS's proposal to bundle CPT 93325 (Color Flow Doppler) into all other echocardiography procedures was NOT included in the final rule. The ACC, along with the American Society of Echocardiography, have worked tirelessly to have this proposal removed. When we work together, amazing things can happen, even in the face of seemingly great odds. The ACC advocacy team, in partnership with ASE and many volunteers, had everything to do with this result--your dues dollars mean something..." Jack Lewin, M.D. Executive Director ACC RHODE ISLAND CHAPTER OF THE AMERICAN COLLEGE OF CARDIOLOGY P.O. Box 40667, Providence, RI 02940-0667 Questions and Comments: ckinney@riacc.org