Physician Ownership Policy

ACC Revises Physician Ownership Policy
It now reads:

The ACCF supports physician ownership in facilities, equipment or services that benefit patients through the delivery of appropriate, high quality, medical care.

Facilities owned in whole or in part by physicians who then refer patients to these facilities should strive to enhance quality of care, efficiency, and patient access, while ensuring that ownership interests are directed to improving the delivery of care through implementation of quality systems and measures. This dedication to clinical excellence should be demonstrated by adherence to the ACCF's evidence-based Practice Guidelines, Quality Standards, and Appropriateness Criteria, as well as participation in quality reporting initiatives such as the National Cardiovascular Data Registry (NCDR) and Society of Thoracic Surgeons (STS) National Database.

Additionally, physician-owned facilities should-as appropriate-pursue laboratory accreditation through the Intersocietal Accreditation Commission, conduct physician certifications, and establish credentialing of support personnel.

Hospital facilities must comply with all Medicare regulations. In particular, hospital facilities must have written policies for managing medical emergencies that occur on site, and must not rely on 911 as a substitute for providing patients emergency services, such as appraisal and initial treatment of emergencies in compliance with Medicare program requirements.

The benefits of physician ownership must be made equally accessible to all patients, with no distinctions made based upon economic considerations. Physician ownership must also be clearly disclosed and transparent to all patients using these facilities.

Physician-owned entities should adhere to all state and federal regulations and abide by the American Medical Association Code of Medical Ethics and the American College of Cardiology's ethical guidelines
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July 2008
Follow-up on Medicare Fee Reimbursement

Dear Colleague,
I am writing to ask you to read Dr. Douglas Weaver's message, which appears below,
with particular attention to PQRI and imaging accreditation -- as well as the appropriateness
criteria demo project. I expect wider acceptance of these criteria by payors in 
the coming years.

Thank you all for your efforts in contacting our legislators and stopping the hemorrhage!
Please, remember to thank your senators and representatives.

Sincerely,

Ganpat Thakker, MD, FACC
West Virginia-ACC President
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Message from Dr. Doug Weaver
Medicare Fee Reimbursement Cuts Halted

It is with a great sense of relief that I report Congress has succeeded in passing
legislation to reverse the 10.6 percent cut in physician payment that took effect
July 1. The battle against these cuts was hard-fought, intensely political and won
only because of the tireless efforts of ACC members like you. During June and July,
members sent over 4,000 e-mails to Capitol Hill and made over 900 phone calls to
 Senators alone. Your phone calls, visits and letters to lawmakers kept up the pressure
and shifted the balance of support necessary to move this legislation forward. If
your Senator voted in favor of the legislation, I encourage you to call and thank
him or her for their help in passing this very important bill. You can reach your
Senator by calling the toll-free Grassroots Hotline at (800) 210-7193. Click
here [http://rs6.net/tn.jsp?t=gob5dpcab.0.0.redyahcab.0&p=http%3A%2F%2Fwww.senate.gov%2Flegislative%2FLIS%2Froll_call_lists%2Froll_call_vote_cfm.cfm%3Fcongress%3D110%26session%3D2%26vote%3D00169%23state&id=preview] to see how your Senators voted.

As passed, the bill will stop the 10.6 percent cut in Medicare reimbursements for
18 months, extend the 0.5 percent payment update for 2008 and provide a 1.1% update
for 2009. In addition, the bill improves and extends payments to rural providers
and continues the Physician Quality Reporting Initiative through 2011. It also 
includes an accreditation requirement for advanced imaging modalities and would 
fund a two-year voluntary appropriateness criteria demonstration project proposed
by the ACC in an effort to refocus the imaging debate toward more quality-focused
policy solutions.

Although the Centers for Medicare & Medicaid Services (CMS) did not process 
claims under the negatively adjusted formula beginning July 1, it will take CMS 
some time to recalibrate its systems to reflect the update. As per previous communications,
the ACC does not recommend that members hold their claims until this adjustment 
occurs.

Thank you for all of your efforts in ensuring the passage of this crucial piece 
of legislation. The ACC will continue to urge Congress now, more than ever, to take
this opportunity to redouble its efforts toward the development of a real and permanent
solution to the payment formula that will allow us to practice medicine in way that
provides the greatest value for our patients.

Sincerely,

Doug Weaver, MD, FACC
ACC President
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June 2008
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Call Your Legislators
Ask Them to Support the Medicare Legislation

Congress is at work on legislation to stop the 10.6 percent cut in Medicare physician
payment before the June 30 deadline. Medicare legislation is expected to be voted
on as early as this week in the Senate! It is critical every ACC member call their
Senators NOW and urge them to vote "YES" on the Medicare bill coming to the floor
this week.

To take action:
Call the ACC's toll-free grassroots hotline at 800.210.7193.  The hotline will walk
you through the entire process and make it easy.

The legislation includes many important elements for the cardiovascular community
and their patients, including an 18-month Medicare payment update of 0.5 percent
for 2008 and 1.1 percent for 2009, an extension of the PQRI through 2011, and positive
incentives for e-prescribing through 2013. The bill also has important imaging policy
changes, including a two-year voluntary appropriateness criteria demonstration project
and an accreditation requirement for advanced modalities.

This bill is good policy for physicians and their patients and we're urging ACC 
members to call their Senators and urge them to vote "YES" on the Medicare bill 
coming to the floor in the coming days.

Call now at 800.210.7193!

It will take all of us acting together to convince Congress and the White House 
to stop the Medicare cuts before June 30. As always, it is critical that when talking
to members of Congress or their staff that you provide them with feedback on how
the cuts and the current regulatory environment are impacting your practices and
ultimately your ability to provide patients with the quality care they deserve.
Thank you in advance for taking action.
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Save the Date - November 21-22, 2008
Plan to attend the WV-ACC Annual Meeting

The Annual Meeting of the West Virginia Chapter of the American College of Cardiology
is slated fto be held in Charleston the evening of November 21 and the day of November
22. We hope to see you there! More details to follow.
Questions? Call the WV-ACC office at 404.303.9950.
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March 2008
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CMS Issues Final Decision

Will Not Limit Coverage of CTA

The Centers for Medicare
& Medicaid Services (CMS) decided NOT to move forward with its
proposed National Coverage Decision (NCD) that would have limited Medicare
coverage of Computed Tomographic Angiography (CTA) to ONLY those instances where
CTA is used as part of an ongoing clinical study meeting certain standards set
by CMS. To read the complete ACC statement, go to: http://www.acc.org/advocacy/advoc_issues/ccta.htm [http://rs6.net/tn.jsp?t=ga4xskcab.0.0.redyahcab.0&ts=S0325&p=http%3A%2F%2Fwww.acc.org%2Fadvocacy%2Fadvoc_issues%2Fccta.htm&id=preview].
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Physician Practice & Hospital Partnership

Please respond...
The American College of Cardiology is composing a master list by state of all Cardiology
practices negotiating or integrated with hospital systems, and researching whether
the experience was positive or negative. This reference guide will serve as a useful
tool for members, and we need your help in gathering details.

We need your help with West Virginia information.Please reply to wvchapteracc@gmail.com
with:
* Names of integrated or integrating practices in your area
* Consultants used
* General experience feedback
Questions? Call the WV-ACC office at 404.303.9950.
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Cardiovascular Screenings

Get the Word Out
CMS needs your help getting the word out about the cardiovascular screening benefit
covered by Medicare. Talk with your patients about their risk factors for cardiovascular
disease and how they can help lessen their risk through lifestyle modifications 
such as diet, physical activity, better control of cholesterol, and smoking cessation
or if necessary with medication. Encourage your Medicare patients not previously
 diagnosed with cardiovascular disease to take full advantage of the cardiovascular
screening blood tests covered by Medicare. It could save their lives.
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Physician Quality Reporting Initiative

Opportunity to Suggest Measures for Inclusion
The Centers for Medicare and Medicaid Services (CMS) is now accepting quality measure
suggestions for consideration for possible inclusion in the proposed set of quality
measures to be published in the 2009 Medicare Physician Fee Schedule (MPFS) Proposed
Rule for the PQRI.
For more information on this opportunity to suggest measures for consideration for
inclusion in 2009, please go to http://www.cms.hhs.gov/PQRI [http://rs6.net/tn.jsp?t=ga4xskcab.0.0.redyahcab.0&ts=S0325&p=http%3A%2F%2Fwww.cms.hhs.gov%2FPQRI&id=preview],
and select the Measures/Codes tab on the left side of the page. Next, scroll down
to the Downloads section and select "Notice of 2009 Measure Suggestions."
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President's Message, March 2008 - Ganpat G. Thakker, MD, FACC

Chapter Wins ACC Award
Steven L. McCormick, MD, FACC, and I attended the ACC Leadership Forum in Washington, DC, at the end of January. We spent a weekend learning about advocacy, communication, quality and education. A highlight of the Forum was the ACC Chapter Recognition Award Dinner. Each year the ACC recognizes the efforts and advancements of exceptional ACC Chapters across the country. It is with great pleasure that we annnounce to you that the West Virginia-ACC was awarded the ACC Chapter Recognition Award for the second straight year! Thank you for helping to make our Chapter so strong.
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West Virginia Health Care Authority Begins Shaping CT Standards - May 2007
The West Virginia Health Care Authority held an open meeting of stakeholders on April 25, 2007, to begin the process of developing standards to judge applications for new CT equipment. Scott Miller, MD, FACC and Ganpat G. Thakker, MD, FACC attended on behalf of the West Virginia ACC chapter. Representatives from the hospital, private payer and industry communities, along with various medical specialties, participated in the meeting. Issues under discussion include whether to require applicants to meet training and competency standards as part of the CON process, and methodologies to identify anticipated need. The stakeholder meetings will continue throughout the spring with a meeting held on May 16 and another scheduled for June 4, with final CON rules expected in mid summer.

SB 266 & HB 2652 | February 2007
Ganpat G. Thakker, MD, FACC, President

Cardiologists must become engaged for regulators and legislators to consider our interests and most importantly the interests of our patients. I urge you to join me in the effort to defeat or amend SB 266 and HB 2652 in the Senate and House Judiciary Committees.   

It is CT now, but in the future it will be ultrasound or EKG. SB 266/HB 2652 makes physicians offices diagnostic centers regulated by the HCA. This is the beginning of HCA's encroachment on physicians and their patients. We must stop it NOW!
 
WV-ACC has coordinated efforts with the West Virginia State Medical Association (WVSMA). We have also worked closely with the national ACC who considers this effort important enough to consider sending staff experienced in state legislative issues to West Virginia to assist us. For that to happen I must have a strong commitment from our membership that you will be active on this issue. Members must call and email legislators. In addition, I will need volunteers to visit Delegates and Senators in Charleston.
 
Please let me know your level of commitment. What will you do to help the cause? I need to hear from you now. Please contact me at gthakker@msn.com or Gwen Goldfarb at wvchapteracc@gmail.com.

West Virginia Legislature to Consider CT CON Legislation | January 2007
Ganpat G. Thakker, MD, FACC, President

Late last year, the Legislative Rule-Making Review Committee of the West Virginia legislature approved a permanent rule that would make the purchase of computed tomography imaging equipment a reviewable service under the West Virginia certificate of need (CON) law. In West Virginia, agency rules must be approved by the legislature and must be introduced as legislation no later than Jan. 29.  Speaker of the House of Delegates Joe Kiss and President of the Senate, Lieutenant Governor Earl Ray Tomblin, will determine how this legislation will be considered. They may refer the bills to their respective health committees for further consideration, or they may send the legislation directly to the floor for a vote. ACC opposes this legislation and will work with the West Virginia ACC to defeat the bill.

West Virginia CT Battle to Continue in the 2007 Legislative Session  
Ganpat G. Thakker, MD, FACC, President

The West Virginia Rule Making Review Committee, an interim joint committee of the West Virginia legislature, approved two rules by voice vote this week that would make the acquisition of computed tomography (CT) equipment reviewable under the state's certificate of need (CON) law. The two CT rules submitted by the West Virginia Health Care Authority (WVHCA) were discussed at length by the committee and many questions were raised as to why the rules were necessary. Although the committee approved the rules by voice vote, many NO votes were cast. The interim committee will recommend the rules to the appropriate legislative committees in the House and Senate when the legislature convenes in January. The ACC will continue to work with the WV-ACC, the West Virginia State Medical Association (WVSMA), the orthopedic and otolaryngology communities, and the National Electrical Manufacturer's Association (NEMA) against the CT rules in the legislature. At the same time stakeholders will also continue to work with the WVHCA to define standards for CT should the rules ultimately prevail. 

 

West Virgnia-ACC News | November 2006
Ganpat G. Thakker, MD, FACC, President

West Virginia Legislative Committee Postpones Consideration of CT CON Rule  The West Virginia Rule Making Review Committee last week postponed consideration of a permanent rule that would make computed tomography (CT) services reviewable under the state's certificate of need law. Discussions between representatives of various groups of physicians who are using imaging technology, the West Virginia State Medical Association, the West Virginia Health Care Authority (HCA),  and the West Virginia Hospital Association, resulted in an agreement to continue talks between the stakeholders. I participated in these discussions on behalf of the WV-ACC. The legislative review committee is scheduled to meet again December 11 and 12 and could consider the CT rule at that time. Stay tuned for further developments.
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West Virginia-ACC News  |  September 2006
Ganpat G. Thakker, MD, FACC, President

CT Moratorium
As you probably know, the West Virginia Health Care Authority issued a moratorium on computed tomography on May 24, 2006. According to the West Virginia Health Care Authority Review, dated June 2, 2006, here is the synopsis:

"May 24, 2006 - Computed Tomography - the West Virginia Health Care Authority ORDERS and declares a moratorium upon the development, acquisition or other establishment of Computed Tomography (CT) services. The replacement of existing CT equipment by existing CT providers is not affected by this moratorium. This moratorium shall continue until the development of State Health Plan Standards for evaluating CT services, or one hundred eighty days from the declaration of this moratorium, whichever is less."

In response to the moratorium order, I wrote a letter to Sonia D. Chambers, chair of the West Virginia Health Care Authority. I explained in the letter that cardiologists have been instrumental in developing procedures for CT angiography and that this moratorium will deny an essential diagnostic tool to the cardiovascular community and results in depriving patients of diagnostic care. The WV-ACC regards this moratorium as a setback for health care policy and the delivery of essential health care services in West Virginia. I further asked what steps have been taken to develop state health plan standards for evaluating CT services. I respectfully requested that the WV-ACC be part of this process. To facilitate an inquiry into the reasons behind this order and the evidence used to arrive at this order, I respectfully requested a public hearing on this matter at the earliest possible date. I will keep you informed when I receive a response.

If you have comments about this matter, please email wvchapteracc@gmail.com.

Meeting with Legislators to Discuss Health Care
This weekend, I will be traveling to Washington, DC, for the ACC's Legislative Conference. I will be meeting with our West Virginia legislators on behalf of West Virginia cardiovascular physicians. The legislators really appreciate hearing about the health care issues directly from the physicians. Even if you're not attending the conference, the ACC has arranged for a Virtual Legislative Conference. Beginning on September 17, log on to the virtual conference site for opportunities to contact your members of Congress about physician payment, HIT and imaging. You can also learn more about the key issues facing cardiology, including a live webcast of the Medicare 101 session taking place on Monday afternoon, September 18. Log on to http://www.acc.org/advocacy/advoc_issues/LegConf2006/virtual.htm beginning on September 17!

Cardiology Coding Seminar on October 18, 2006
Please plan to attend the Cardiology Coding & Reimbursement Seminar scheduled for October 18, 2006, at The Holiday Inn Civic Center in Charleston, WV. Complete details and a copy of the brochure can be found at http://accwv.org/12804/index.html
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West Virginia-ACC News  |  March-April 2006
George W. Shehl, MD, FACC, Immediate Past President

My tenure as your ACC Governor and West Virginia-ACC Chapter President ended during the Annual Meeting of the American College of Cardiology in Atlanta, GA.  That meeting was fantastic with some interesting findings from new late-breaking clinical trials including the CHARISMA, ACUITY, and ASTEROID trials to name a few.  In addition, a new medication (ranolizine) for angina pectoris will soon be available.  Cardiac CT and MR imaging are getting better every day.  As non-invasive testing, they may end up replacing diagnostic caths in selected patients before too long.  Cardiologist training criteria have been established.

It was truly a pleasure for me to serve as your WV-ACC Governor/Chapter President from 2003 to 2006.  Over the past 3 years, I was able to implement a chapter electronic listserv as a means of communication between all of us. We had some great Chapter Receptions at National Meetings.  In addition, I hired a very bright and competent chapter executive, Ms. Gwen Goldfarb, who set up our WV-ACC Chapter web site at www.accwv.org.    Please visit this website to find out all of the latest cardiology news in our state from individual cardiologists’ achievements, to chapter activities and meetings.  I helped to organize our first WV Chapter CME meeting, which will take place on Saturday May 6, 2006, at Stonewall Resort.  The subject matter of the meeting centers around diabetic education for cardiologists, promoted by the National ACC to help cardiologists become more knowledgeable about diabetes and the medicines used to treat this common condition.  Industry will be helping to support us at the meeting, so please try and attend not only for the education and fun, but to help us maintain a healthy chapter. The registration is FREE!! The Golf is great!! Register today by calling (877) 603-8638.

I would also like to introduce you to our new Governor/Chapter President, Dr. Ganpat Thakker, who is an FACC from Charleston, WV.  Dr. Thakker has been working very hard during his preparation as governor-elect.  He has attended several ACC leadership meetings to help give him the tools to lead our chapter to new heights of advocacy, education, and professional satisfaction for West Virginia cardiologists.   To help achieve those goals, I encourage each and every one of you to monitor the activity on our website, give him a call, and get involved in chapter activities.  He must have your support to make those good things happen.

I hope to see many of you at the Stonewall Resort Diabetic Education Initiative Cardiology Meeting on May 6.  On a final note, I bid you farewell as your past governor and wish to express my steadfast support for our new leader, Dr. Thakker.

Sincerely,

George W. Shehl, MD, FACC
Past-Governor WV-ACC, 2003-2006

WEST VIRGINIA-ACC NEWS  |  MARCH 2006
Deficit Reduction Act Passses
We are writing with good news about our lobbying efforts. In September, Dr. Ganpat Thakker, spent time visiting West Virginia Congressmen in Washington, DC, on behalf of all West Virginia-ACC members. Dr. Shehl sent correspondence to legislators and heard back from them on this issue. As you probably heard, The House passed the Deficit Reduction Act of 2005 on February 8, 2006, by a vote of 216-214, replacing the 4.4 percent Medicare physician payment cut that took effect Jan. 1 with a freeze at 2005 levels, retroactive to January 1. We hope that you'll continue to support our advocacy efforts on behalf of West Virginia cardiovascular physicians -- together we can make a difference.

Dr. Robert Touchon Wins 2006 Legacy of Life Award
In recognition of his outstanding contributions to the field of cardiology and assistance in the advancement of public health initiatives, Robert Charles Touchon, MD, will receive the American Heart Association’s 2006 Legacy of Life Award, Saturday, February 25, 2006 during the American Heart Association Masquerade Ball. 

A graduate of Saint Louis University School of Medicine, Dr. Touchon is currently with the Huntington Internal Medicine Group in Huntington, West Virginia.  He was the 1994-97 President of the West Virginia Chapter of the American College of Cardiology, the 1986-89 President of the Southwestern Division - West Virginia Board of Directors of the American Heart Association and the 1992-93 President of the West Virginia Affiliate of the American Heart Association.  Dr. Touchon was recognized as the Clinical Teacher of the Year from the Marshall University School of Medicine four years in a row beginning in 1985.  He has published countless articles and serves on numerous committees. 

The prestigious Legacy of Life Award is presented annually and honorees are selected based on their life-long dedication and accomplishments in the fight against heart disease and stroke.  Recipients of the Legacy of Life award have also been instrumental in improving the lives of countless members of our community.

Join the American Heart Association in congratulating Dr. Touchon on this esteemed accomplishment.