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ACC Sues HHS Secretary Over Payment Cuts

by Brendon Nafziger, DOTmed News Associate Editor | December 31, 2009
Suit over doctor pay
The American College of Cardiology filed a lawsuit against the Department of Health and Human Services Secretary Kathleen Sebelius on Monday to halt upcoming Medicare payment cuts to doctors they say will drive cardiologists out of private practice.

The complaint, filed in the U.S. District Court in the Southern District of Florida, hopes to block the 2010 Medicare Physician Schedule from going into effect on January 15, 2010.

ACC believes the Center for Medicaid and Medicare Services (CMS) schedule change, which cuts Medicare reimbursements to cardiologists by almost 40 percent, is based on faulty data and will limit patient access to critical diagnostic tests.

The suit names the Florida ACC Chapter, American Society of Nuclear Cardiology, the Association of Black Cardiologists and the Cardiology Advocacy Alliance as co-plaintiffs.

Payment cuts

The suit alleges that the 2010 Medicare Physician Schedule will cut reimbursements for common heart tests an ACC spokeswoman says are sometimes called "today's stethoscopes."

The revised payment schedule will slash echocardiogram reimbursements by 42 percent and nuclear medicine test payments by 36 percent for cardiologists in private practice, according to the ACC.

The doctors group believes the lost income will cause cardiologists to lay off staff, close clinics or even migrate to hospitals, which are largely unaffected by the pay cuts. They say internal polls among their own members suggest more than one-fifth of cardiologists are considering abandoning their practice and moving to a hospital or another practice.

These changes wouldn't just hurt cardiologists, ACC argues. They say that many cardiac patients would lose access to life-saving diagnostic work, as heart doctors could stop providing these tests, or possibly all non-emergency care, to Medicare beneficiaries. And patients in rural areas or communities far from hospitals would be hardest hit, as the closing of practices could force them to travel long distances to get care or otherwise go without critical services.

"What they're in effect doing is running private practice out of business, and basically the patients and the system pay more money to get the same tests in the hospital, while limiting access to patient care in rural areas and taking doctors away from the communities," Amy Murphy, a spokeswoman for ACC, tells DOTmed News.

Survey called faulty

The CMS is basing their belief that the costs of running a private practice are declining on a faulty survey, ACC says.

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