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Breaking the Rule
the data line
23rd Oct, 2009 | Source : Jack Lewin

The tension related to the Medicare 2010 Physician Payment Rule is mounting. CMS must already have some idea what it plans to do on Nov. 1 when it must give public notice of its proposed final rule (which still has to be signed off by the OMB and the White House). But, we have no idea where CMS is going with it. There are lots of rumors.

The best thing would be for CMS to amend this before they issue it. I believe I impressed the White House last week on the importance of this, and I further know the WSJ editorial has had an impact. If primary care were to have a guaranteed payment update through another mechanism to take the pressure off this issue, CMS might be willing to hold up the Rule for all specialties until the validation of the data could be undertaken more responsibly.

ACC has always been a solid supporter of helping out our beleaguered primary care colleagues. As such, we are considering sponsoring a parallel bill to health care reform that would give primary care a needed boost directly as part of reform, and without the unintended but very bad consequences of trying to reallocate payment and reimbursement from specialties to primary care in a zero sum game. In CV medicine, we will face serious shortages as the tsunami of obesity and diabetes-related CV morbidity crashes toward us. If the Rule proceeds, a cardiology access crisis will immediately follow.

So, if such primary care legislation were to succeed, the Rule might more palatably be delayed with respect to non-primary physician specialties until the obviously unrepresentative data could be validated and a fair, amended rule could be issued. But this would be a very difficult maneuver to create. It’s our aim that CMS undertake to remedy the situation NOW on its own. Given the catastrophic consequences of its implementation otherwise, all of our energy and resources are focused on amending or delaying the Rule. ACC President Alfred Bove, M.D., F.A.C.C., and I will host an ACC all-member call on Nov. 12 from 4:00-5:30 p.m. (EST) to discuss the 2010 rule. To RSVP for the call, click here.



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the data line
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