Known as the Physician Practice Information Survey (PPIS), it suggests that the costs of private cardiology have dropped 40 percent in the past five years. But the ACC argues the survey relies on a small, unrepresentative sample of cardiologists who did not face financial pressures typical of practicing cardiologists.

"There were only 55 responses from cardiologists that they based the entire rule on," Murphy explains.


"Our own data, the MGMA [Medical Group Management Association] data and MedAxiom data show that practice expenses are rising," she says, referring to the supplemental survey ACC conducted, as well as data gathered by practice and management consulting groups.

According to the complaint, the cardiologists in the CMS survey had lower expenses than most, as they didn't incur costs from purchasing radiopharmaceuticals, intravenous drugs for pharmacological stress tests, echocardiography contrast agents or extensive clinical staff.

ACC says even The Lewin Group, a company HHS tapped to analyze the data, believes the PPIS results are off base.

"CMS has historically used precision testing to test the reliability of survey
results for cardiology and other physician practice expenses," ACC tells DOTmed News by email. "When CMS switched to the new PPIS, it abandoned precision testing of the practice expense survey data."

ACC believes its own survey conforms to proper precision levels by having the right sample size, among other factors.

When reached by DOTmed News, a spokeswoman for the HHS said they do not comment on open cases.

In addition to the lawsuit, ACC has launched a public relations campaign to generate opposition to the new payment rates. It is also filing legislation with Congressman Charlie Gonzalez (D-TX) to keep cardiologist reimbursements at the 2009 level, while allowing other specialties to operate at the new rates.

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