News

ACC Testifies on MitraClip

The ACC and The Society of Thoracic Surgeons (STS) on March 20 testified before the U.S. Food and Drug Administration (FDA’s) Circulatory System Devices Panel of the Medical Devices Advisory Committee. In a day-long hearing, the panel examined Abbott Vascular Inc.’s pre-market approval application for the MitraClip® System and its use in patients who are considered too high risk for open mitral valve surgery. After listening to numerous accounts from experts, patients and Abbott, the advisory panel voted in favor of approval. John Carroll, MD, FACC, and Fred Edwards, MD, FACC underscored the importance of appropriate patient selection and heart team collaboration in treating this inoperable patient population, and addressed the role registries play in post-market surveillance. The ACC and STS earlier submitted joint comments that provided valuable guidance for the panel to take into account during its decision making. The FDA’s decision will be closely monitored and updates will be communicated via CardioSource.org, the ACC Advocate and @Cardiology on Twitter.

ACC Weighs in on FDA's Drug Shortage Plan

The College recently provided formal input to the FDA on its plan to address shortages of drugs and biologics. As part of the reauthorization of the Prescription Drug User Fee Act, the FDA is required to create a plan addressing the alarming number of drug shortages that currently exist. The FDA decided to expand this effort to include potential shortages of biologics, as well and put together a task force to make recommendations to Agency leadership regarding improvements in procedures and other potential changes to address current problems. To assist in its work, the Task Force sought input from stakeholders regarding potential problem areas and improvements. Given the troublesome shortages affecting cardiology patients today, the College weighed in and will continue to work diligently on this issue. More information on the FDA's drug shortages initiative, including a list of drugs currently experiencing shortages and FDA recommendations, can be found here.

Were You in A Graduate or Fellowship Program Between 1995 and 2005?

In 2010, the U.S. Internal Revenue Service (IRS) announced the exemption of medical residentsfrom Federal Insurance Contributions Act (FICA) taxes based on the student exception for tax periods ending before April 1, 2005, when new IRS regulations went into effect. Since the announcement, the IRS has contacted hospitals and universities as well as medical residents who filed FICA refund claims for these periods with more information and procedures, and many ACC members have already received their reimbursements. Those who were in a residency/fellowship program in the U.S. between 1995 and 2005 are encouraged to contact their respective program's office of graduate medical education to see if they qualify for the tax refund claim. Read more.

May 1 Signals Changes to Ordering/Referring Process

After a lengthy delay, the Centers for Medicare and Medicaid Services (CMS) announced that, beginning on May 1, it will implement edits to prevent payment for services ordered or referred by providers not enrolled in the Medicare program. The policy was first announced in 2009 and was delayed amid the numerous concerns raised by the ACC, the American Medical Association and others. Enrollment does not require that providers be participating in the Medicare program, merely that their information is contained within CMS’ provider database. The ACC recommends that cardiologists check their Medicare provider enrollment information to ensure it is current and accurate. For details on the changes, additional ACC recommendations and a sample letter for referral sources, visit CardioSource.org.

Sequester Cuts Slated for April 1

The Centers for Medicare and Medicaid Services (CMS) announced that the effects of the sequester will begin to impact physician and hospital payments for Medicare services on April 1. As a result of the requirements, the Medicare portion of the payments will be reduced by 2 percent. The patient portion should not be reduced as a result of this requirement; therefore, copays will not be impacted. As a matter of rule, Medicare pays 80 percent of an allowed charge and the patient portion is 20 percent, although that portion is often covered by Medigap or secondary insurance. CMS also confirmed that contractors will not be issuing new fee schedules. The College has requested further clarification on how this policy will effect payments in the long term and will continue to communicate with CMS.

New Research from CardioSurve on Patient-Centered Care

Immediate Past ACC President William Zoghbi, MD, MACC called for a strong focus on patient-centered care during his tenure, and the March issue of the CardioSurve newsletter could not be more timely. The four-page newsletter features articles touching on new patient-focused research done through CardioSurve surveys over the past few months. CardioSurve is managed by ACC Market Intelligence staff and goes out to a panel of more than 300 U.S. cardiologists each month with questions on various health care topics. Take a look at the newest issue here.

Wise Words, Many Thanks from ACC Leaders at ACC.13

ACC’s presidential duties were passed on from William Zoghbi, MD, MACC to John Gordon Harold, MD, MACC at ACC.13 in San Francisco, and both leaders shared their thoughts, wise words and gratitude during their convocation addresses. Read more about their vision for the future and what they said to the new FACC and AACCs here.

ACC Member Value Column: A Focus on CardioSmart

CardioSmart, the ACC’s patient education and empowerment initiative sets out to help individuals prevent, treat and manage cardiovascular disease. Here’s how CardioSmart is making a difference in the lives of your patients – and why ACC members should take a second look:

• Members can sign up for CardioSmartTV for free – adding an exciting new element to patient waiting rooms with television content about heart disease education and healthy lifestyle choices. Sign up here.
• The initiative’s home on the web, CardioSmart.org, was re-launched at ACC.13 with a number of upgraded features including more than 30 condition centers – available in both English and Spanish (and soon, Arabic!) – as well as site personalization and interaction with peers in new online communities.
• Mobile applications make educating your patients and ensuring they have all of the support they need easy! CardioSmart offers two free texting streams – CardioSmartTXT QUIT for those looking to stop smoking and CardioSmartTXT PREVENT for patients seeking tips to prevent heart disease. A new Med Reminder app helps patients take medications as prescribed, and the CardioSmart Explorer app is a great way to bring heart conditions to life for your patients.

For more on all of the benefits of ACC’s CardioSmart initiative, visit CardioSmart.org. Other ACC member benefits are online here.

New on the ACC in Touch Blog:

Check out the ACC’s Blog at blog.cardiosource.org for multiple posts each week on hot topics. Here are some of the newest posts:

• ACC Board of Governors Chair David May, MD, PhD, FACCshared a link to the video of the House Ways and Means Committee Health Subcommittee meeting on MedPAC’s annual March report to Congress.
• Gerard R. Martin, MD, FACC, chair of the ACC’s Adult Congenital and Pediatric Cardiology Council touched on collaboration ACC has with the annual Congenital Heart Advocacy Day, led by the Adult Congenital Heart Association (ACHD) . Martin shared a quote from Barbara DeMaria, an ACHA parent ambassador, about her experience in raising a song with CHD.  “There is still much work to do – and more Advocacy Days to be had – but working together I am confident that we can continue to make progress in the treatment of congenital heart disease patients, like DeMaria’s son, all along the care continuum,” he said.
• A March 15 Blog post focused on Twitter and social media at the very successful ACC.13 meeting in San Francisco. BOG Chair David May, MD, PhD, FACC said that ACC.13 was “the most ‘connected’ meeting to date with more than 5 million impressions worldwide.”
• New ACC President John Gordon Harold, MD, MACC talks about his path to ACC presidency on the “shoulders of giants” like mentor Dr. Jeremy Swan in a March 12 post.

ACC.13 is Over – But the Science and News Remain!

It’s been a few weeks since ACC.13 in San Francisco wrapped, but the news and science from the meeting remains. Check out all of the happenings from ACC.13 and TCT@ACC-i2 on CardioSource here. The comprehensive digital library with more than 400 hours of presentations from the meeting is now available.Get iScience, the Meeting on Demand ™ program, to check out the sessions you missed.

Special ACC Partnership Helps You Save on Medical Liability Coverage

Founded by doctors for doctors, The Doctors Company has partnered with the ACC to provide discounts on medical liability coverage for ACC members. The Doctors Company provides a unique combination of coverage features, aggressive claims defense, superior protection, and unrivaled rewards, including the Tribute® Plan, a groundbreaking financial benefit that rewards members for their loyalty and commitment to outstanding patient care. Visit CardioSource.org/TheDoctorsCompany to get a no-obligation quote and more information.

Stay In Touch with the ACC Via Social Media

Stay in touch with the ACC and the latest clinical and advocacy news through ACCinTouch. ACCinTouch connects ACC members and those interested in cardiovascular news through popular social networking channels like Facebook, Twitter, LinkedIn and YouTube. Look for the ACCinTouch logo for the official ACC presence on these social media channels in order to connect with ACC members and those interested in cardiology. In addition to the ACC's main Twitter profile @ACCinTouch, the College also has profiles dedicated to the ACC.13 Annual Meeting @ACC_2013 as well as news from the Advocacy team @Cardiology. CardioSmart, the ACC's patient education and support program, also has patient-centered cardiovascular news available through Facebook, Twitter @CardioSmart, and YouTube. For more information about ACC’s social media channels, visit CardioSource.org/ACCinTouch.

New AUC Methodology and ICD/Cardiac Resynchronization AUC Released

The American College of Cardiology (ACC) has released changes to the process for developing appropriate use criteria (AUC), including changes to frequently misinterpreted terminology for describing the levels of appropriateness of care. Under the updated methodology, published on Feb. 21 in the Journal of the American College of Cardiology, appropriateness of procedures or use of imaging for specific populations will be described as "appropriate," "may be appropriate," or "rarely appropriate." The new terminology and definitions more accurately reflect how AUC should be used for quality improvement and clinically, including consideration for physician judgment, measurement of patterns of use over time and the potential hazard of applying inflexible rules to individual patient situations," said AUC Writing Committee Chair and lead author Robert C. Hendel, MD, FACC. The new terminology will be applied in development of all subsequent appropriate use criteria. The first new AUC document using the new terms was released on Feb. 28 and is focused on implantable cardiac defibrillators and cardiac resynchronization. Learn more on CardioSource.org.

ACC.13 is Around the Corner; Prep with New Meeting Tools

The ACC.13 eMeeting Planner App and Online Planner tools are available to easily explore sessions, presentations and speakers. In addition, you can browse PDFs of the sessions — by day or by pathway —in order to easily plan your itinerary. Learn more about all the planning tools available to help you make the most of ACC.13! Also plan to follow the ACC on Twitter, Facebook and the ACC in Touch Blog for the latest news and discussions related to the meeting. Coverage of the meeting will be available here, as well.

Special Session at ACC.13 for Military/Public Health Members

Are you a Department of Defense, Veterans Affairs (VA) or Public Health member? Attend a special breakout session just for you on March 10 from 12 – 2 p.m. at ACC.13, hosted by the ACC Board of Governors. Topics will include the future of VA Cardiac Implantable Electrophysiology Device Management, the Million Hearts initiative, and a panel discussion concerning the transition from military to civilian practice. The meeting will include lunch and will be held at the San Francisco Marriott Marquis in room Golden Gate C1. RSVP here or contact Ashton Futral with questions.

ACC Goes Mobile

With the increase in use of technologies such as Smartphones, tablets and e-readers, the ACC has developed several mobile resources to help both CV professionals and patients. Highlights of each app are as follows:

• The new CardioSmart Explorer App is free to ACC members and is now also available to the general public for a nominal fee (to download the App click here). The app is available for the iPad 2 and is designed to help explain medical conditions and procedures to patients at the point of care.
• The new ACC Connect App for members is available for both iOS (iPhone, iPad, and iTouch) and Android devices, and allows cardiovascular professionals to stay connected through their electronic devices. Features include a searchable member and ACC staff directory, the ability to update individual contact information, news feeds from the ACC, and access to important ACC phone numbers. To download on an iOS device, click here.
• The ACC also offers ways to review CardioSource.org content via iPhone, iPod touch, iPad, Android and Blackberry through the CardioSource Mobile App.
• Several of ACC’s print publications feature apps including the JACC iPad edition App; the Cardiology magazine App available for the iPad, iPhone and iPod touch; and the CardioSource World News App for the iPad. Other mobile resources include heart songs and ACCEL.
• The free CardioSmart Med Reminder app is designed to help patients take their medications as prescribed in addition to serving as a personal medication record (PMR) to help patients communicate to their health care providers about medications.
• Coming soon: The Anticoag Evaluator App will debut at ACC.13. The app, a product of the new Anticoagulation Initiative, is designed to help calculate patient bleeding and stroke risk, as well as help clinicians choose antithrombotic therapy options based on clinical trials (ACTIVE-A, RE-LY, ROCKET-AF, ARISTOTLE).

Health Insurance Exchanges on the Horizon

Starting Jan. 1, 2014 all states must have fully operational Health insurance exchanges in place. Health insurance exchanges, also known as HIXs or marketplaces, will be a one stop shop for all individuals and small businesses to compare and choose among an array of affordable, comprehensive options, and purchase health insurance plans. The states have been preparing for these exchanges since the Affordable Care Act was enacted in 2010 and have had a choice to opt for a state based exchange, federally facilitated exchange or a partnership exchange. The exchanges will certify and offer plans that cover the 10 categories of essential health benefits (EHBs) required as part of the ACA. The proposed rule for the EHBs was released in November 2012 and the final rule is expected soon.

Cardiology Teams Up Against Cuts to Medicare, Research and Review Process

The ACC and the American Society of Clinical Oncology (ASCO) recently sent a letter to President Barack Obama taking aim at the “triple threat” of across the board cuts to Medicare, the research infrastructure, and the drug and device review process that both cardiology and oncology face. Without stable federal funding, continued advances in diagnostics, drug and device therapies, prevention and public education for cardiovascular disease and cancer—the two leading causes of death in the U.S.—are in jeopardy. The College and ASCO reconfirmed support for a reformed Medicare physician payment system that ensures cost-effective quality care for patients nationwide.

"Ever Expanding Digital Age" Prompts Changes to HIPAA

The U.S. Department of Health and Human Services (HHS) this month released privacy and security updates to the Health Insurance Portability and Accountability Act (HIPAA). While the previous law primarily focused on ensuring providers and health plans protected health information, the latest changes extend these requirements to "business associates" including contractors and subcontractors. Additionally, the updates detail requirements for reporting Health Information Technology for Economic and Clinical Health (HITECH) breaches to HHS. As a follow-up, HHS released sample business associate agreement language for bringing contracts into compliance with the updated rule. For covered entities and business associates, the compliance deadline for most requirements is Sept. 23, 2013. Changes to existing agreements must be made by September 2014.

ACC President Focuses on An Opportunity to Shape the Future

In the February President’s Page, published in the Feb. 5 issue of the Journal of the American College of Cardiology (JACC), William A. Zoghbi, MD, FACC, highlights the history, principles, and concerns surrounding public reporting, opportunities for registries and professional societies moving forward, and why it’s time to engage. “Armed with valid and robust data, meaningful performance measures, and a commitment to continuous improvement, cardiovascular specialists and the care teams that assist them will be well-prepared to thrive in an era of public reporting and to lead the way toward a more transparent, and healthier, health care system,” writes Zoghbi.

New Data Standards Released for ACS and CAD

Key elements and definitions for the clinical management of patients with acute coronary syndromes (ACS) and coronary artery disease (CAD) were published in JACC this month. The new clinical data standards aim to standardize terminology and help improve transfer of health data for research initiatives, clinical registries, structured reporting, and use within electronic health records to enhance effective communication among health care professionals. Complete coverage is available here.

Effects of Sunshine on the Health of Cardiology

The Centers for Medicare and Medicaid Services (CMS) recently released the long-awaited final regulation implementing the Physician Payment Sunshine Act, also referred to as the PPSA or Sunshine Act. The rule, passed as part of the Affordable Care Act, requires public reporting by manufacturers of medical products and group purchasing organizations (GPOs) of all payments or transfers of value to physicians and teaching hospitals, as well as ownership or investment interests held by physicians or immediate family members of physicians in such manufacturers and GPOs. Although required by Congress to implement the law and begin data collection by Jan. 1, 2012, the lengthy delays in the release of the proposed and then final regulations by CMS mean that data collection will not begin until Aug. 1, 2013, delaying reporting by applicable manufacturers and GPOs to CMS until March 31, 2014 and public reporting until Sept. 30, 2014. Get the details on who the law applies to, what must be reported, the impact on research, how the rule will impact ACC involvement, and more.

Report Highlights Cost of Freezing SGR

Budget and Economic projections for 2013-2023, released by the Congressional Budget Office recently, shed light on the true cost of a ten year freeze of the Sustainable Growth Rate (SGR). The updated projection stands at $138 billion, more than $100 billion below earlier estimates. This steep drop stems from lower than expected Medicare physician spending growth. Read the full report.

Medicare Audit Efforts Escalate

A report released by CMS unveiled a significant jump in recovery efforts by Medicare Audit Contractors (RAC) from 2010 to 2011. For fiscal year 2011, RACs returned $488 million in improper payments to the Medicare Trust Fund. While almost $500 million was actually returned, RACs identified and corrected overpayments and underpayments of $939 million in 2011 compared to $92 million in 2010. In addition to Medicaid and Medicare Part D, RAC efforts are expected to expand to Medicare Part C this summer. Learn more about RACs on CardioSource.org.

Have You Put Choosing Wisely into Practice?

The College is interested in hearing from you about how the Choosing Wisely® campaign, an initiative of the ABIM Foundation that aims to spark conversations about appropriate care between physicians and patients, is affecting the way you practice. Are you having more conversations with your patients about avoiding unnecessary care? How are those conversations playing out, and how are they being received by patients? What is working well, and what—if anything—is proving to be more challenging? Please share your story by emailing advocate@acc.org. Read more about the success of the campaign.

FDA Approves IDE for ACC and STS to Study Alternative Approaches to TAVR

The U.S. Food and Drug Administration (FDA) has granted an investigational device exemption (IDE) to the American College of Cardiology (ACC) and The Society of Thoracic Surgeons (STS) to conduct a study assessing alternative access approaches for transcatheter aortic valve replacement (TAVR). Currently, only the transfemoral approach to TAVR using the Edwards SAPIEN valve and, in some cases, the transapical approach have been approved in the U.S. However, an estimated one out of four patients are not eligible for this approach due to inadequate vessel size, vessel disease and/or other anatomical considerations. The IDE – the first-ever filed for by either organization – will assess the safety and effectiveness of alternative access approaches (i.e. axillary, transapical, transaortic, subclavian/axillary) in these patients with severe aortic stenosis who are inoperable or extreme risk patients where transfemoral insertion is contraindicated. Read more on CardioSource.org.

Revamped CardioSmart.org Launched This Month

CardioSmart.org rolled out its revamped collection of digital tools and resources this month designed to help individuals prevent, treat and manage cardiovascular disease. The updated new site includes more than 30 robust cardiovascular condition centers, available in English and Spanish, that guide patients through each stage of their journey including causes, symptoms and treatments. Users can personalize their page by identifying topic areas of interest and by saving noteworthy news or questions to ask their doctor to their dashboard. CardioSmart.org tools such as Find a Drug, Preparing for Your Next Appointment and Ask an Expert enhance the patient-provider relationship. Users can set goals with their care team and track progress using our weight, waist, blood pressure, and activity trackers and our heart risk, BMI and cholesterol calculators. Users can also connect with peers on our online communities, take heart healthy challenges, earn CardioSmart points and spend them in our CardioSmart Store.

Important Deadline Approaching PQRS

March 14 is the deadline to participate in the CMS 2012 Physician Quality Reporting System (PQRS). You can still use the ACC PQRIwizard to submit your data. The 2012 PQRS incentive payment is equal to 0.5 percent of allowed charges for Part B covered services. Learn more.

Special ACC Partnership Helps You Save on Medical Liability Coverage

Founded by doctors for doctors, The Doctors Company has partnered with the ACC to provide discounts on medical liability coverage for ACC members. The Doctors Company provides a unique combination of coverage features, aggressive claims defense, superior protection, and unrivaled rewards, including the Tribute® Plan, a groundbreaking financial benefit that rewards members for their loyalty and commitment to outstanding patient care. Visit CardioSource.org/TheDoctorsCompany to get a no-obligation quote and more information.

Stay In Touch with the ACC Via Social Media

Stay in touch with the ACC and the latest clinical and advocacy news through ACCinTouch. ACCinTouch connects ACC members and those interested in cardiovascular news through popular social networking channels like Facebook, Twitter, LinkedIn and YouTube. Look for the ACCinTouch logo for the official ACC presence on these social media channels in order to connect with ACC members and those interested in cardiology. In addition to the ACC's main Twitter profile @ACCinTouch, the College also has profiles dedicated to the ACC.13 Annual Meeting @ACC_2013 as well as news from the Advocacy team @Cardiology. CardioSmart, the ACC's patient education and support program, also has patient-centered cardiovascular news available through Facebook, Twitter @CardioSmart, and YouTube. For more information about ACC’s social media channels, visit CardioSource.org/ACCinTouch.

ACC Gears Up to Celebrate Heart Month 2013

February is Heart Month! Don’t miss out on these engaging and exciting Heart Month activities led by the College and CardioSmart. Join the national heart health awareness movement that is being embraced by millions who share the common goal of better heart health for all women.

• Wear Red Day Thunderclap, Sign Up Before Feb. 1: Together, we can take a stand to promote heart health for all Americans. Join the ACC’s Thunderclap and help us spread the message on a mass scale that heart disease is largely preventable. Sign up today here.
• Feb. 1 Twitter Chat (#MyHeartChat): The ACC, the National Heart, Lung and Blood Institute’s The Heart Truth® campaign and BET Networks will hold a special Twitter chat on Feb. 1. The chat will last for one hour and will focus on women’s heart disease, African American heart health disparities, and motivation for women to protect their hearts. While participating in the chat, you will be prompted to ask questions, which will be answered live by an expert from the ACC, The Heart Truth, or BET. Joanne Foody, MD, FACC, will represent the ACC. Spread the word about the chat and participate in the conversation on Feb. 1. To join the conversation, use the hashtag #MyHeartChat on Twitter.
• Feb. 6 Red Dress Fashion Show Live Stream
  The ACC and the National Heart, Lung, and Blood Institute (NHLBI) have joined together to support women's heart health through The Heart Truth® Red Dress Collection 2013 Fashion Show on Feb. 6 as part of Fashion Week in New York City. The live stream will be available on The Heart Truth Facebook page.
• Feb. 14 National Heart Health Awareness Day
  On Feb. 14, CardioSmart will team up with Diet Coke to conduct free heart risk screenings and educational awareness at major national health care institutions and academic medical centers across the U.S. For more information, visit CardioSmart.org.

CardioSmart.org Gets a Red Carpet Rollout

This February, CardioSmart.org rolls out its revamped collection of digital tools and resources designed to help individuals prevent, treat and manage cardiovascular disease. The updated new site includes more than 30 robust cardiovascular condition centers, available in English and Spanish, that guide patients through each stage of their journey including causes, symptoms and treatments. Users can personalize their page by identifying topic areas of interest and by saving noteworthy news or questions to ask their doctor to their dashboard. CardioSmart.org tools such as Find a Drug, Preparing for Your Next Appointment and Ask an Expert enhance the patient-provider relationship. Users can set goals with their care team and track progress using our weight, waist, blood pressure, and activity trackers and our heart risk, BMI and cholesterol calculators. Users can also connect with peers on our online communities, take heart healthy challenges, earn CardioSmart points and spend them in our CardioSmart Store.

ACC Criticizes CMS Payment Policy Decisions

The ACC opposed major payment policy decisions related to percutaneous coronary intervention (PCI) in comments submitted to CMS on the 2013 physician fee schedule. The College urged CMS to reconsider its decisions on PCI during 2014 rulemaking. The letter also critiqued changes made to ablation values and several decisions that deviated from the recommendations of the AMA RUC. Additional review of work values for ablation procedures and TAVR refinement panels was also recommended. Read more.

Important Deadlines Approaching for E-Prescribing, EHRs and PQRS

Don't miss these upcoming deadlines:

• Jan. 31 is the last day for physicians to submit e-prescribing hardship exemption requests to avoid the 1.5 percent payment penalty in 2013. Hardship exemption categories include:
• The physician is unable to e-prescribe as a result of local, state or federal law or regulation.
• The physician wrote fewer than 100 prescriptions during the period of Jan. 1-June 30, 2012.
• The physician practices in a rural area that doesn't have sufficient high-speed Internet access.
• The physician practices in an area that doesn't have enough pharmacies that can do e-prescribing.
• Hardship exemption requests for the 2014 payment penalty will be accepted during a separate period this year. View e-prescribing FAQs on CardioSmart.org and visit CMS' e-prescribing website for more detailed information.
• Feb. 28 is the last day for Medicare eligible professionals to complete attestation in order to receive an incentive payment for 2012 Electronic Health Record (EHR) Incentive Program participation. In order to qualify, you should have completed your 2012 reporting period requirements by Dec. 31, 2012. More information is available from CMS.
• March 14 is the deadline to participate in the CMS 2012 Physician Quality Reporting System (PQRS). You can still use the ACC PQRIwizard to submit your data. The 2012 PQRS incentive payment is equal to 0.5 percent of allowed charges for Part B covered services. Learn more.

How Has Choosing Wisely Affected Your Practice?

Last April, the ACC, along with eight other medical specialty societies, helped launch the Choosing Wisely® campaign by releasing a list of "Five Things Physicians and Patients Should Question" in cardiology. Choosing Wisely, an initiative of the ABIM Foundation, aims to promote conversations between physicians and patients to reduce overused or unnecessary tests and procedures not supported by evidence, and where the benefits are outweighed by potential harms. The College is interested in hearing from cardiovascular professionals about how the campaign is affecting their practice. Is there an increase in patient conversations about avoiding unnecessary care? How are those conversations playing out, and how are they being received by patients? What is working well, and what—if anything—is proving to be more challenging? Share your story by emailing advocate@acc.org. Read more about the campaign and stay tuned for more information on a CME education module, Consumer Reports patient fact sheets and the Feb. 20 roll out of additional lists from other medical specialty societies.

New Rule Protects Patient Privacy, Secures Health Information

The U.S. Department of Health and Human Services (HHS) recently released privacy and security updates to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in an effort to help protect patient health information in an ever expanding digital age. This updates are designed to strengthen the government’s ability to enforce HIPAA, as well as enhances patient’s privacy protections. Get the details.

Upcoming HIMSS Conference to Spotlight Health IT

Professionals from across the health care spectrum will come together to discuss health IT issues and review innovative solutions designed to transform health care at the 2013 HIMSS Annual Conference and Exhibition on March 3 – 7 in New Orleans. Topics on the agenda include ICD-10, clinical business intelligence, health information exchanges, clinical engineering, innovation, meaningful use, nursing informatics, physicians' IT, and RFID and RTLS in health care. More than 300 peer-reviewed sessions, including workshops and roundtables, round out education offerings at HIMSS13. Learn more.

Fiscal Cliff Bipartisan Deal Reached

After months of watching to see how Congress would navigate the so-called "fiscal cliff," lengthy negotiations resulted in a bipartisan deal on Jan. 1 when the House of Representatives and the Senate passed the American Taxpayer Relief Act of 2012, averting tax increases and spending cuts from simultaneously going into effect. However, a key offset included in the bill increases the overpayment recovery period for Medicare audit programs from three to five years. Although this provision has not received extensive coverage in the last couple of weeks, it has the potential to substantially impact providers. Stay tuned for details on how the Centers for Medicare and Medicaid Services (CMS) will implement this provision on the ACC in Touch Blog and CardioSource.org.

FDA Updates

Head to CardioSource.org for additional updates and the most up to date list.

• Jan. 10: An FDA advisory panel recommended approving canagliflozin (Invokana), a novel type 2 diabetes drug. Part of a class of SGLT2 inhibitors, the drug blocks blood glucose from being reabsorbed by the kidney, expelling it via urine. If approved, canagliflozin would be the first of its kind on the market. While the panel voted 10-5 in favor of approving the drug, several concerns were raised, including early cardiovascular events and stroke. Several panelists expressed the need for a cardiovascular outcomes study before the drug is approved. The decision will head to the FDA next.
• Jan. 3: The FDA approved the XIENCE Xpedition(TM) Everolimus Eluting Coronary Stent System, which is particularily beneficial for patients with complicated coronary anatomies. The XIENCE stents, manufactured by Abbott, are currently the only stents approved for direct stenting in the U.S.

ACC Welcomes Chief Digital Officer to Lead Digital Coordination Division

Steve Kerchner joined ACC officially on Jan. 16 as chief digital officer and senior vice president for the newly created Digital Coordination Division. Kerchner will lead the development and implementation of a new digital strategy for the ACC that ensures a unified and consistent experience across digital platforms, improves and enhances the College's digital offerings, and facilitates greater communication among stakeholders. For more on Kerchner and ACC’s digital strategy, visit CardioSource.org.

Newest ACC Magazines Now Available

The most recent issue of Cardiology magazine is now available and focuses on the value of ACC membership in terms of advocacy, quality and lifelong learning as well as across career stages and paths. Read more here. Also, you can find the newest issues of CardioSource InterventionalNews and CardioSourceWorldNews magazine online.

New on the ACC in Touch Blog:

• A new post authored by Jeffrey L. Anderson, MD, FACC, chair, Jonathan L. Halperin, MD, FACC, chair-elect and Alice K. Jacobs, MD, FACC, immediate past chair of the ACCF/AHA Task Force on Practice Guidelines delves into the guideline development process in a Jan. 14 post.
• ACC President William Zoghbi, MD, FACC gears up for ACC.13 in a Jan. 12 post which highlights some of the unique meeting offerings including 16 learning pathways, a robust meeting mobile application, and the launch of the revamped CardioSmart.org and the Lifelong Learning Portfolio.

Register for ACC.13 in Advance to Save!

ACC heads to San Francisco for ACC.13 and TCT@ACC-i2 on March 9 – 11. Advance registration ends Jan. 30. For more details on how to save on attending the year’s most important meeting in cardiovascular care, visit ACC.13 online.

Associate Editors for the Lifelong Learning and MOC Editorial Board Wanted

The Education Division of the American College of Cardiology (ACC) is seeking associate editors for its Lifelong Learning and MOC Editorial Board. The term will be for a minimum of a one-year appointment that will begin in March 2013. The deadline to submit applications is Feb. 1, 2013. To apply, please submit a letter of application addressing your qualifications for the position, along with a brief statement of your vision for your role as an editor, and your résumé. Letters of application should be addressed to ACC and sent via e-mail to Mary Ward at mward@acc.org. For more information on the position, visit CardioSource.org.

Special ACC Partnership Helps You Save on Medical Liability Coverage

Founded by doctors for doctors, The Doctors Company has partnered with the ACC to provide discounts on medical liability coverage for ACC members. The Doctors Company provides a unique combination of coverage features, aggressive claims defense, superior protection, and unrivaled rewards, including the Tribute® Plan, a groundbreaking financial benefit that rewards members for their loyalty and commitment to outstanding patient care. Visit CardioSource.org/TheDoctorsCompany to get a no-obligation quote and more information.

Stay In Touch with the ACC Via Social Media

Stay in touch with the ACC and the latest clinical and advocacy news through ACCinTouch. ACCinTouch connects ACC members and those interested in cardiovascular news through popular social networking channels like Facebook, Twitter, LinkedIn and YouTube. Look for the ACCinTouch logo for the official ACC presence on these social media channels in order to connect with ACC members and those interested in cardiology. In addition to the ACC's main Twitter profile @ACCinTouch, the College also has profiles dedicated to the ACC.13 Annual Meeting @ACC_2013 as well as news from the Advocacy team @Cardiology. CardioSmart, the ACC's patient education and support program, also has patient-centered cardiovascular news available through Facebook, Twitter @CardioSmart, and YouTube. For more information about ACC’s social media channels, visit CardioSource.org/ACCinTouch.

ACC President Speaks on ‘The State of Cardiology’ During Grand Rounds

During a recent Grand Rounds presentation at the Methodist Hospital System in Houston, Texas, ACC President William Zoghbi, MD, FACC, delved into the current cardiovascular landscape, including health care challenges and innovations on the horizon. Zoghbi discussed the ACC's recent Practice Census, touching on the evolution of practice ownership, electronic health record adoption and shifting demographics. Patient-centered care was also a hot topic and Zoghbi highlighted tools available through ACC's CardioSmart initiative, including the CardioSmart Explorer app (available in the app store) that's designed to enhance the clinician/patient relationship at the point-of-care.

WHO Establishes Health Targets to Combat NCDs

The World Health Organization has established nine health targets designed to combat non-communicable diseases (NCDs) worldwide. Last September, the United Nations (UN) General Assembly declared the need for global control and prevention of NCDs at the first ever UN Summit on NCDs. Since then, the ACC has played a pivotal role in the development of a plan for the global campaign to combat the diseases. On the one-year anniversary of the summit, the ACC jointly published a health policy statement with the World Heart Federation, the European Society of Cardiology and the American Heart Association that pushed for concrete targets. Two months after this call to action, the targets were finally agreed upon under the NCD alliance's tireless guidance. Moving forward, the ACC plans to leverage its 6,000 international members and 24 International Chapters to ensure success when national plans are implemented next year. For more information, or to get involved in these continuing efforts to curb the growing global burden of NCDs, contact international@acc.org.

Looking Ahead to 2013

CMS released the final 2013 Medicare Physician Fee Schedule in early November. The rule unveiled major changes in cardiology coding for next year. Of note, new CPT codes have been created to report PCI as well as bundle EP studies with ablation. Additionally, the physician work RVUs that were finalized result in physician work RVU reductions of roughly 20 percent to the family of PCI codes and roughly 27 percent to the family of EP/ablation codes. The ACCF/AMA CPT Reference Guide for Cardiovascular Coding is your one-stop resource for navigating these coding changes. Learn more and order your copy. For additional final rule details on the proposed multiple procedure payment reduction; Physician Quality Reporting System (PQRS) and e-prescribing participation; and more, visit CardioSource.org.

New Guidelines for SIHD Released

New, comprehensive guidelines released by the ACC Foundation (ACCF)/American Heart Association (AHA) Task Force on Practice Guidelines, in partnership with several other medical specialty societies, aim to provide physicians with a framework to optimally diagnose and manage patients with stable ischemic heart disease (SIHD). Among the topics covered: guideline-directed medical therapy as the cornerstone of treatment for most patients; how to optimally care for women and other subgroups of patients who may be more prone to complications; the use of newer imaging and diagnostic technologies; the role of catheter-based and surgical procedures in treatment; the value of patient preferences in decision making; and the need for careful follow up to monitor for progression of disease and adherence to therapy. Read more.

ACCPAC-Supported Candidates Win in November

Results are in! Over the course of the 2012 cycle, ACC's Political Action Committee (ACCPAC) supported 122 candidates throughout the country who formulate and control the policies that impact health care for patients with cardiovascular disease; facilitate the delivery of high-quality, cost-effective cardiovascular services; and fund cardiovascular research and prevention. This November election results were very much in the College's favor, with over 90 percent (104) of ACCPAC-supported candidates winning their elections. Learn more about how contributing to ACCPAC is an investment in your practice, your profession and your future. Now that the elections are over, how will the new Congress shape health reform? Learn more at the Cardiovascular Summit this January, where health policy leaders, payers and other stakeholders will delve into the impacts of the elections on health reform implementation. View the agenda and reserve your spot.

New on the ACC in Touch Blog:

• ACC President William Zoghbi, MD, FACC delves into the Evolution of the Journal of the American College of Cardiology (JACC) journals in a Nov. 19 post which also touches on the ongoing search for a new JACC editor-in-chief and the new JACC Journals presence on Facebook.


• William R. Lewis, MD, FACC, chair of the ACC’s shared decision making work group and a member of the patient-centered care steering committee, shares his thoughts on improving outcomes through shared decision making in the latest post in the quality series by ACC Quality leaders.


• The link between diabetes and cardiovascular disease is explored in a number of posts throughout November as part of National Diabetes Month. For example, Joanne Foody, MD, FACC, editor of CardioSmart.org, discusses the growing diabetes epidemic that is expected to impact one in three Americans by 2050 (check out a special infograph on ACC's Facebook page for other staggering statistics and share it with your patients). CardioSmart offers a number of tools to help patients manage the disease, including a collection of patient fact sheets, the CardioSmart med reminder app and the CardioSmartTXT program. Learn more about these and additional resources on the Blog.

Value-Based Payment Phase-In Coming

In 2015, the Centers for Medicare and Medicaid Services (CMS) will begin phasing in payment adjustments for quality and cost of care starting with groups of 100 or more professionals who opt-in. While participation in value-based payment will be voluntary at first, CMS intends that all physicians' payments will be adjusted in 2017 using a value-based modifier. The ACC will host a webinar on Dec. 4 at 3 p.m. EST to underscore the need for practices to get ready for value-based purchasing initiatives that were outlined in the 2013 Medicare Physician Fee Schedule. Get the information, instruction and resources you need to understand the implications. Register here. Also, check out the November/December issue of Cardiology for more on this topic.

FDA Update on Zilver PTX Stent

The U.S. Food and Drug Administration (FDA) recently announced approval of the first drug-eluting stent for use in patients with peripheral artery disease (PAD). The Zilver PTX Stent will expand treatment options for patients with PAD beyond the current options that include exercise, drug therapy, balloon angioplasty, bare-metal stenting or surgical bypass. According to Christy Foreman, director of the Office of Device Evaluation at FDA's Center for Devices and Radiological Health, a clinical trial "demonstrated that the Zilver is more effective than balloon angioplasty for the treatment of symptomatic peripheral artery disease in above-the-knee femoropopliteal artery." Read the complete FDA statement.

New Expert Consensus Document on Troponin Elevations

The ACC Foundation (ACCF) recently released the first Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations. Developed in collaboration with other leading professional societies, the document is the first comprehensive consensus document outlining clinical considerations for ordering and interpreting tests for troponin. The new document provides a framework for clinicians to interpret the results of troponin testing "in a useful mechanism-based construct." Full coverage is available on CardioSource.org.

Membership Dues Deadline Dec. 10

ACC membership renewal is due on Dec. 10. Membership provides more than $1,800 worth of benefits each year and helps cardiovascular professionals stay up-to-date on the latest in cardiovascular care and at the top of their field. Visit CardioSource.org/Dues to renew.

Newest ACC Magazines Now Available

The most recent issue of Cardiology magazine is now available and focuses on the value of ACC membership in terms of advocacy, quality and lifelong learning as well as across career stages and paths. Read more here. Also, you can find the newest issues of CardioSource InterventionalNews and CardioSourceWorldNews magazine online.

Don’t Miss CV Summit!

Cardiovascular Summit: Solutions for Thriving in a Time of Change
Las Vegas; Jan 10 – 12 , 2013
Enhance your knowledge of the evolving healthcare environment to ensure the clinical and business success of new practice models and clinical care designs. Presentations and workshops will synthesize the status of health care reform, explore strategies that will facilitate successful navigation of the maze of expected healthcare changes. Attendees can expect to learn more about finance and evolving payment models, designing a successful CV service line, creating an effective team, and leadership and governance within an organization. Register here. To see all upcoming conferences offered by the ACC, visit here.

Special ACC Partnership Helps You Save on Medical Liability Coverage

Founded by doctors for doctors, The Doctors Company has partnered with the ACC to provide discounts on medical liability coverage for ACC members. The Doctors Company provides a unique combination of coverage features, aggressive claims defense, superior protection, and unrivaled rewards, including the Tribute® Plan, a groundbreaking financial benefit that rewards members for their loyalty and commitment to outstanding patient care. Visit CardioSource.org/TheDoctorsCompany to get a no-obligation quote and more information.

Special ACC Partnership Helps You Save on Medical Liability Coverage

Founded by doctors for doctors, The Doctors Company has partnered with the ACC to provide discounts on medical liability coverage for ACC members. The Doctors Company provides a unique combination of coverage features, aggressive claims defense, superior protection, and unrivaled rewards, including the Tribute® Plan, a groundbreaking financial benefit that rewards members for their loyalty and commitment to outstanding patient care. Visit CardioSource.org/TheDoctorsCompany to get a no-obligation quote and more information.

ACC Can Help Plan Your Chapter State Advocacy Strategy

Each state, including DC and Puerto Rico, legislature will convene next year and a comprehensive advocacy strategy can ensure success in 2013. ACC’s state government relations team is available to help Chapters design their strategy in cooperation with Chapter Advocacy Council and Committee calls. Working together, the collaboration will help to identify key issues and determine how best to communicate the Chapter's concerns to lawmakers. Contact Frank Ryan, Jim Boxall, and Saiza Elayda to begin strategizing.

Stay In Touch with the ACC Via Social Media

Stay in touch with the ACC and the latest clinical and advocacy news through ACCinTouch. ACCinTouch connects ACC members and those interested in cardiovascular news through popular social networking channels like Facebook, Twitter, LinkedIn and YouTube. Look for the ACCinTouch logo for the official ACC presence on these social media channels in order to connect with ACC members and those interested in cardiology. In addition to the ACC's main Twitter profile @ACCinTouch, the College also has profiles dedicated to the ACC.13 Annual Meeting @ACC_2013 as well as news from the Advocacy team @Cardiology. CardioSmart, the ACC's patient education and support program, also has patient-centered cardiovascular news available through Facebook, Twitter @CardioSmart, and YouTube. For more information about ACC’s social media channels, visit CardioSource.org/ACCinTouch.

State of the States Reports due Nov. 1

Attached you will find the October edition of ACC News You Can Use. You can incorporate these short news pieces into your Chapter newsletters, emails and/or websites. These news items provide updates on key ACC initiatives, research or legislative efforts; new or upcoming educational programs, webinars or products; and hot topic ACC in Touch Blog or CardioSource Community discussions. As always, ACC corporate communications staff are at your service to assist in gathering additional information on these topics or more news items. Please contact Autumn Niggles with any questions, comments or suggestions.

ACC Returns to the White House

In early October, ACC member and Washington, DC, Chapter Governor Stuart Seides, MD, FACC, joined several physician specialist groups at the White House to discuss delivery system transformation. Several of President Obama's top health care advisors joined the discussion, including Richard Gilfillan, MD, director of the Centers for Medicare and Medicaid Innovation, Jeanne Lambrew, deputy assistant to the president for health policy, Jon Blum, deputy administrator and director of Medicare at the Centers for Medicare and Medicaid Services (CMS) and Nancy Nielsen, MD, PhD, senior advisor to the Secretary of Health and Human Services. During the course of the discussion, Seides had the opportunity to highlight the exciting programs the College has implemented that achieve both improved care coordination and high quality efficient health care, including the Imaging in FOCUS initiative, the National Cardiovascular Data Registry (NCDR®) and PINNACLE Registry®, and the SMARTCare program.

Multiple Procedure Payment Reduction in Proposed Rule

The recently released CMS 2013 Medicare Physician Fee Schedule Proposed Rule includes an expansion of multiple procedure payment reduction (MPPR) policy that would negatively impact payment by imposing a 25 percent payment reduction on the technical component for the less expensive service if more than one service is provided on the same day to the same patient. The ACC has reviewed the expanded MPPR policy and believes a payment reduction is not the appropriate course of action. Thanks to the grassroots efforts of ACC members, 60 members of Congress recently signed on to a House Energy and Commerce Committee Members Marsha Blackburn (R-TN) and John Barrow (D-GA) to CMS Acting Administrator Marilyn Tavenner opposing the proposed MPPR expansion. CMS’ decision will be part of the final rule, which is due out in late October/early November. Stay tuned to The ACC Advocate newsletter for details.

New CathPCI Registry Report Provides View of U.S. Usage

In an effort to provide a perspective on current use and outcomes of invasive cardiac procedures, a new report using data from the NCDR's® CathPCI Registry® was published on Oct. 17 in the Journal of the American College of Cardiology. The report provides a contemporary snapshot of diagnostic cardiac catheterization and percutaneous coronary interventions (PCI) performed in the U.S. To understand the impact of the 2012 Focused Update on the CathPCI Registry AUC metrics, visit www.ncdr.com/cathpci/auc.

Blog Post Focuses on Readmission Penalties

The unintended consequences of readmission penalties are explored in a recent ACC in Touch Blog post. Judy Tingley, MPH, RN, member of the ACC's Clinical Quality Committee, warns health care professionals to brace for impact following the CMS readmission payment penalties that went into effect on Oct. 1. This early in the game, the consequences of these financial penalties on more than 2,200 hospitals with readmission rates above the national averages are "yet to be determined." However, it's clear that "safety net" hospitals will be impacted the most. ACC's Hospital to Home (H2H) program is hard at work to reduce all-cause readmissions among patients with heart failure or acute myocardial infarction in hospitals across the country. Read more about readmissions and H2H.

NCDR® As a Model for Success

A new paper published in the Journal of the American College of Cardiology focuses on the need for enhanced data validation as the use of registry data expands, and specifically looks at the Data Quality Program developed by the ACC's National Cardiovascular Data Registry (NCDR®) as a model for success. Under the program, which was created to ensure the completeness, consistency, and accuracy of data submitted to NCDR registries, data are filtered through a data quality report using registry-specific algorithms that require predetermined levels of completeness and consistency before being included in a registry. Next, internal quality assurance protocols enforce data standards before reporting. Finally, 300 to 625 records per registry are audited annually within 25 randomly identified sites. Moving forward, "the objective of the next generation of quality assurance is to ensure quality through a rapid learning system that combines mutually supporting components within the NCDR," the authors note. Read the full article.

Membership Dues Deadline Coming Soon

ACC membership renewal is due on Dec. 10. Membership provides more than $1,800 worth of benefits each year and helps cardiovascular professionals stay up-to-date on the latest in cardiovascular care and at the top of their field. Visit CardioSource.org/Dues to renew.

PCORI Seeking Research Input

As part of its effort to refine its research agenda, The Patient-Centered Outcomes Research Institute (PCORI) is offering health care professionals and other interested parties the chance to submit research recommendations based on their own health care questions. Offer ideas on PCORI's website.

New CardioMetabolic Health Alliance Formed

The American College of Cardiology, the National Minority Quality Forum (NMQF), and the American Association of Clinical Endocrinologists have joined forces to launch the CardioMetabolic Health Alliance. The objective of the Alliance is to improve cardiometabolic risk factor control in diverse populations, including high blood pressure, elevated fasting blood sugar, dyslipidemia, abdominal obesity (waist circumference) and elevated triglycerides; and to provide more effective and coordinated care for people with established cardiometabolic disorders. Learn more about the Alliance in a new ACCinTouch Blog post from Gary Puckrein, PhD, president and CEO of NMQF.

Committee and Council Applications due Oct. 31

The College is accepting nominations and applications for committee and council membership now through Oct. 31. All ACC Fellows (FACC/MACCs), Fellows-in-Training (FITs), Cardiac Care Associates (CCAs) and Cardiovascular Administrators are invited to nominate a colleague or apply for membership. As a member-driven organization, major activities at the ACC are led and decided by members in groups like the College’s committees and councils. ACC Committees represent issues that permeate all areas and specialties of cardiovascular care but align with one of the College’s core areas including advocacy, quality, education or membership. Councils are focused member groups that advise the Board of Trustees and focus on a broad range of issues within their specialty or clinical area. To get involved, apply online at services.acc.org/CommitteeNominations.

ACC CEO Search Underway

The College is now soliciting applications for the Chief Executive Officer with the first interviews beginning in early December. Read the full job description here. The College has selected Korn/Ferry International to work with the College's Search Committee.

Newest ACC Magazines Now Available

The most recent issue of Cardiology magazine is now available and features an overview of ACC efforts to develop an overarching digital strategy. Read more here. Also, you can find the newest issues of CardioSource InterventionalNews and CardioSourceWorldNews magazine online.

Don’t Miss These Upcoming ACC Meetings

From one side of the U.S. to the other, these two upcoming ACC meetings offer insight into advanced science and tools to navigate the changing landscape of cardiovascular practice. To see all upcoming conferences offered by the ACC, visit here.

• NY Cardiovascular Symposium:
  New York City; Dec. 7 – 9
  Examine the most advanced methods and technologies available to treat cardiovascular disease at this three-day conference, directed by Valentin Fuster, MD, PhD, MACC. The event features a distinguished group of cardiovascular experts who will discuss and debate cutting-edge issues that impact your profession and your practice. Register here.


• Cardiovascular Summit: Solutions for Thriving in a Time of Change
  Las Vegas; Jan 10 – 12 , 2013
  Enhance your knowledge of the evolving healthcare environment to ensure the clinical and business success of new practice models and clinical care designs. Presentations and workshops will synthesize the status of health care reform, explore strategies that will facilitate successful navigation of the maze of expected healthcare changes. Attendees can expect to learn more about finance and evolving payment models, designing a successful CV service line, creating an effective team, and leadership and governance within an organization. Register here.

Special ACC Partnership Helps You Save on Medical Liability Coverage

Founded by doctors for doctors, The Doctors Company has partnered with the ACC to provide discounts on medical liability coverage for ACC members. The Doctors Company provides a unique combination of coverage features, aggressive claims defense, superior protection, and unrivaled rewards, including the Tribute® Plan, a groundbreaking financial benefit that rewards members for their loyalty and commitment to outstanding patient care. Visit CardioSource.org/TheDoctorsCompany to get a no-obligation quote and more information.

ACC Can Help Plan Your Chapter State Advocacy Strategy

Each state, including DC and Puerto Rico, legislature will convene next year and a comprehensive advocacy strategy can ensure success in 2013. ACC’s state government relations team is available to help Chapters design their strategy in cooperation with Chapter Advocacy Council and Committee calls. Working together, the collaboration will help to identify key issues and determine how best to communicate the Chapter's concerns to lawmakers. Contact Frank Ryan, Jim Boxall, and Saiza Elayda to begin strategizing.

Stay In Touch with the ACC Via Social Media

Stay in touch with the ACC and the latest clinical and advocacy news through ACCinTouch. ACCinTouch connects ACC members and those interested in cardiovascular news through popular social networking channels like Facebook, Twitter, LinkedIn and YouTube. Look for the ACCinTouch logo for the official ACC presence on these social media channels in order to connect with ACC members and those interested in cardiology. In addition to the ACC's main Twitter profile @ACCinTouch, the College also has profiles dedicated to the ACC.13 Annual Meeting @ACC_2013 as well as news from the Advocacy team @Cardiology. CardioSmart, the ACC's patient education and support program, also has patient-centered cardiovascular news available through Facebook, Twitter @CardioSmart, and YouTube. For more information about ACC’s social media channels, visit CardioSource.org/ACCinTouch.

ACC Celebrates World Heart Day

This September the ACC celebrated the World Heart Federation’s World Heart Day with educational outreach and events. The College provided educational awareness of the global effect of heart disease, plus educational and social events for staff and a community outreach event focusing on the theme of women/children’s heart health. Some of the events included a special Heart Café for ACC staff at Heart House in Washington, DC; a special Twitter Chat focused on women’s heart health; and tie-ins to the local Houston community taking part in the first of four Spirit of the Heart events with the Association of Black Cardiologists this year An archive of the Twitter chat, which featured representatives from CardioSmart, the National Heart Lung and Blood Institutes, Million Hearts™ and Healthfinder.gov, is available on the ACC’s Facebook page. For more on Spirit of the Heart events, go to CardioSmart.org

AFib Awareness Month

As part of September’s Atrial Fibrillation (AFib) Awareness Month, the ACC launched an Atrial Fibrillation Toolkit to provide tools and strategies for the patient care team to support high-quality care for patients with AFib. In addition, the ACCinTouch Blog featured a series of blog posts highlighting AFib all month authored by ACC leaders like Richard Kovacs, MD, FACC and ACC President William Zoghbi, MD, FACC. Visit ACC's special AFib Facebook tab for a collection of AFib resources. For more on ACC’s AFib tools and resources, click here.

Spirit of the Heart: A Community Call to Action to Prevent Heart Disease

CardioSmart and the Association of Black Cardiologists (ABC) are partnering to further both missions of patient-centered care and patient engagement, while also reaching out to local communities nationwide to promote cardiovascular health. This fall, ACC and ABC will hold several weekend Spirit of the Heart health events, which will target the nation’s minority and underserved communities, and will integrate social, economic, cultural and political dimensions specifically related to patient health. The events provide a variety of activities over a three day span, beginning with an invitation-only community leadership dinner; a health fair open to the public to include free health screenings and risk assessments; and visits by community leaders, health advocates and local ACC members to area churches to further the message of heart-healthy living. The kick off 2012 Spirit of the Heart event will be held in Houston, Texas, where ACC President William Zoghbi, MD, FACC, will deliver opening remarks during the welcome dinner. In addition, Keith Ferdinand, MD, FACC, will participate in the panel discussion. Events will also be held in Dallas where BOG Chair-Elect David C. May, MD, PhD, FACC will speak on the panel and Austin, Texas, Harlem, N.Y., and Oakland, Calif., to coincide with ACC.13 in San Francisco. For more information about the Spirit of the Heart events and to become involved, please contact Cherie Black.

New Health Policy Statement Urges Global Action to Stop Preventable CV Deaths

The Global Cardiovascular Disease Taskforce, a group of experts representing the ACC Foundation (ACCF), World Heart Federation, American Heart Association, European Heart Network and European Society of Cardiology, jointly released a health policy statement urging timely global action to save preventable death from cardiovascular disease (CVD), including heart disease and stroke. On the one year anniversary of the United Nations High-level meeting on NCDs, the taskforce this month is calling on government and the cardiovascular community to accelerate the progress on the commitments made last year and support the ten evidence-based targets, including the top four exposure targets on physical activity, tobacco, dietary salt intake and hypertension/blood pressure. By focusing on these four key targets, the goal is to achieve a number of goals by 2025. In addition, the taskforce recommends the uptake of a set of interventions designed by the World Heart Organization, which includes cost-effective treatments that can be delivered regardless of the income level of a country. These include the widespread adoption of multidrug therapy regiment of aspirin, a statin, and blood pressure-lowering agents to prevent heart disease and stroke and to treat those with, or at high risk of, heart disease and stroke. Read more on CardioSource.org.

Practice Census Reveals Continued Change in Landscape

A new ACC survey of more than 2,500 practices provides a comprehensive snapshot of the current state of cardiology. Respondents from all 50 U.S. states and Puerto Rico provide insight into the state of the cardiovascular practice today and the continuing trend towards hospital integration. According to the College’s 2012 Practice Census, while physicians remain the primary owner for the majority of cardiovascular practices, the number of physician-owned practices continues to decline, while hospital ownership is on the rise. Compared to 2007 when physicians owned 73 percent of practices and hospitals owned 8 percent, the new data show only 60 percent of practices are now physician-owned, while 24 percent are hospital-owned. Read more from the Census here.

Registration Now Open for Upcoming Meetings

Fall brings many things – cooler weather, football and open registration for some of the year’s most exciting ACC meetings:

• The first Sports Cardiology Summit: Protecting the Heart of the American Athlete is just around the corner on Oct. 19 and 20 at Heart House in Washington, DC. The event will focus on topics like epidemiology of sudden death, cardiac diagnostics, sports electrophysiology, exercise prescription and more.
• Registration is now open for the 45th Annual New York Cardiovascular Symposium held Dec. 7 to 9 at the Hilton New York in New York City. The event, directed by Valentin Fuster, MD, MACC, will focus on major topics in cardiology including coronary artery disease, valvular heart disease, cardiac and electrical failure, and atrial fibrillation.
• Registration and housing is now open for ACC.13 and TCT@ACC-i2 in San Francisco for March 9 – 11, 2013. Join thousands of colleagues and move from “discovery to delivery” during the three-day event of the year. The Call for Abstracts and Challenging Cases opens Oct. 1.
• The Cardiovascular Summit: Solutions for Thriving in a Time of Change held Jan. 10 – 12, 2013 in Las Vegas is now open for registration. The event arms attendees with the knowledge, leadership skills and tools necessary to positively affect change in their practice environment.

Get Involved with Committee and Council Membership

The College will accept nominations and applications for committee and council membership through Oct. 31. All ACC Fellows (FACC/MACCs), Fellows-in-Training (FITs), Cardiac Care Associates (CCAs) and Cardiovascular Administrators are invited to nominate a colleague or apply for membership. ACC Committees represent issues that permeate all areas and specialties of cardiovascular care but align with one of the College’s core areas including advocacy, quality, education or membership. Councils are focused member groups that advise the Board of Trustees and focus on a broad range of issues within their specialty or clinical area. To get involved, apply online at services.acc.org/CommitteeNominations.

BOG and CCA Liaison Elections Coming This Fall

The chance to elect College and Chapter leaders is right around the corner. Board of Governors (BOG) and Cardiac Care Associate (CCA) Liaison elections open Oct. 16 and will close Nov. 13 at 5 p.m. EST. A new addition to the election cycle this year is the presence of guidelines for service as governor. The Governor Nominations Committees are equipped with these new guidelines for selection of the candidates for the position of governor to the domestic states, D.C., Puerto Rico to ensure that the elected official can fulfill his or her duties and uphold the ACC standards of leadership. CCA members can simultaneously place their vote for the next Cardiac Care Associate (CCA) Liaison in their state this fall. Visit CardioSource.org/Elections for more information and details on the election process, or contact National ACC Chapters staff at 202-375-5413.

Complex Office Visits Face Scrutiny

The ACC recently learned that Connolly, the Medicare Recovery Auditor (RAC) for Region C, has received approval to conduct in depth medical review on claims submitted for complex office visits, specifically those billed with CPT code 99215. Affected states include Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia, Puerto Rico and the U.S. Virgin Islands. Because of the type of review being conducted, the RAC will be permitted to extrapolate their findings based on a statistical sample of such claims. It remains unclear as to whether Connolly will be auditing claims for problems with 99215 billing throughout the entire region or in a subset of the region. The Centers for Medicare and Medicaid Services (CMS) does expect to receive requests from other RACs to review for the same or similar code(s). The ACC, along with the larger physician community, raised concerns three years ago with respect to potential audits of E&M services. The College continues to raise these concerns and will work with the American Medical Association (AMA) and other physician groups to advocate on behalf of cardiologists. To learn about your region's RAC and the issues for which it has been given permission to audit, click here. Get additional information on the Medicare Recovery Auditor program.

Brush Up on Coding Requirements

The CPT book and the ACC/AMA Reference Guide for Cardiovascular Coding offer comprehensive guidance to proper coding. A key point to remember is that Outpatient Established Patient visits need two of three components and Outpatient New Patient visits need three of three components. For example, 99215 and 99205 require comprehensive history; comprehensive examination; and medical decision making of high complexity. Look out for the 2013 ACCF/AMA CPT Reference Guide for Cardiovascular Coding this fall.

Successful ACC 2012 Legislative Conference

More than 350 cardiovascular professionals descended on Capitol Hill to tackle issues facing cardiology from Sept. 9 to 11. The 21st Annual Legislative Conference kicked-off with a special dinner celebrating the 10th anniversary of ACC's Political Action Committee and remarks from Pulitzer Prize winner George Will. The conference featured a full-day of sessions that explored the state of cardiology and hot button issues in health care, followed by a day of face-to-face meetings with lawmakers. While on the Hill, attendees urged Congress to avoid further harmful health care spending cuts and reform the Medicare payment system. The College also sponsored a Congressional briefing on women's heart health in collaboration with WomenHeart. As we face another round of sustainable growth rate cuts, sequestration and potential imaging cuts, the relationships established this week will ensure the voice of cardiology is heard loud and clear in upcoming health care discussions. For full coverage of the conference, visit CardioSource and the ACC in Touch Blog.

Opportunity to Get Additional PQRS Bonus for MOC

The American Board of Internal Medicine (ABIM) recently announced that its Maintenance of Certification (MOC) program has been approved to give physicians who also successfully participate in the Medicare Physician Quality Reporting System (PQRS) an additional bonus. Physicians would be required to be successful participants in PQRS for 2012 and also complete MOC elements more frequently than required for the actual maintenance of the certification. Successful participants in PQRS in 2012 will receive a bonus equal to 0.5 percent of allowed charges — completing this program would double that bonus opportunity to 1 percent of allowed charges. The ABIM will submit information directly to CMS on successful participation in this program. Physicians still have the opportunity to participate successfully in PQRS in 2012 through the use of the PQRI Wizard. More details on the ABIM program requirements can be found here.

ACC Urges Congress on Sequestration Provision and SGR

The ACC in September signed-on to a joint letter urging Congress to nullify the Budget Control Act's sequestration provision and the Sustainable Growth Rate (SGR) formula. The letter reaffirms the medical community's commitment to high-quality, high-value, coordinated care and highlights the importance of providing a stable payment environment for health care professionals in order to propel medical innovation. Read more.

New Recommendations Expand Indications for CRT

New joint guidelines for device-based therapy of cardiac rhythm abnormalities were recently released by the ACC Foundation, American Heart Association and Heart Rhythm Society. Chief among the updates to the 2008 guidelines are expanded indications for cardiac resynchronization therapy (CRT) and device follow up. When it comes to CRT, the document clarifies and provides recommendations about which patients are most likely to benefit from the therapy based on recent clinical trials, such as the MADIT-CRT trial, RAFT trial, REVERSE trial and MIRACLE ICD II trial. Read more and check out the Cardiac Rhythm Management Community.

ICD Use in the Spotlight

According to press reports, the US Department of Justice (DOJ) is getting closer to wrapping up its two-year long investigation into claims for implantable cardioverter defibrillators (ICDs). Hospitals around the country reportedly received e-mails yesterday asking them to conduct self-audits of their ICD cases and providing them with a model for resolution of the investigation. The penalties levied against each of the hospitals will vary, based on the severity of harm, prior knowledge of wrongdoing, existence of a compliance program and other such factors. To review the Medicare National Coverage Determination on ICDs, click here. Read more on CardioSource.

Readmissions Penalties Kick in Oct. 1

Hospitals will begin to have their payments adjusted based on readmission rates as of Oct. 1. This policy, implemented as part of the Affordable Care Act (ACA) of 2008, will reduce payments to hospitals by as much as 1 percent if they have particularly high readmission rates for patients with heart failure, acute myocardial infarction and pneumonia. The readmissions measures are based on performance between the middle of 2008 and the middle of 2011. Most hospitals will receive very small payment adjustments under this policy. Learn more about payment adjustments for hospitals regionally. Through the Hospital to Home program, the ACC is working to reduce unnecessary hospitalizations throughout the country. Learn more about the program here.

ICD-10 Date is Official

The Department of Health and Human Services (HHS) finalized a proposed one-year delay for ICD-10 compliance, officially setting the deadline to Oct. 1, 2014. HHS confirmed the deadline while announcing the establishment of a unique health plan identifier, a new health care standard that stems from the ACA. Find out what you need to know about ICD-10.

White Paper Guides CV Service Line Success

A new white paper from the ACC's Council on Clinical Practice describes the various aspects of developing and managing a successful cardiovascular (CV) Service Line. Currently, CV care accounts for a large percentage of overall health care costs. The transition from traditional fee-for-service payment models to value-based payment models has encouraged physicians and hospitals to work collaboratively to provide more efficient and less costly health care. The paper delves into the building blocks for a successful CV Service Line including, dynamic leadership, a strong but flexible organizational structure and a commitment to a physician/hospital partnership. Download the paper here.

Recap from ESC in Munich

The European Society of Cardiology (ESC) Congress 2012 wrapped at the end of August in Munich, Germany, and the ACC was on the scene covering the latest science. In addition to the release of the Third Universal Definition of Myocardial Infarction, hot trials included:

• FAME 2: Fractional flow reserve-guided percutaneous coronary intervention versus optimal medical therapy in stable coronary artery disease
• TRILOGY ACS: Prasugrel versus clopidogrel for patients with unstable angina/non-ST-elevation myocardial infarction but without revascularization
• IABP-SHOCK II: Treatment with intra-aortic balloon counterpulsation (IABP) compared with no IABP among patients with acute myocardial infarction and cardiogenic shock

For full coverage from ESC 2012, visit the meeting coverage page on CardioSource.

Social Media Channels

Stay in touch with the ACC and the latest clinical and advocacy news through ACCinTouch. ACCinTouch connects ACC members and those interested in cardiovascular news through popular social networking channels like Facebook, Twitter, LinkedIn and YouTube. Look for the ACCinTouch logo for the official ACC presence on these social media channels in order to connect with ACC members and those interested in cardiology. In addition to the ACC's main Twitter profile @ACCinTouch, the College also has profiles dedicated to the ACC.13 Annual Meeting @ACC_2013 as well as news from the Advocacy team @Cardiology. CardioSmart, the ACC's patient education and support program, also has patient-centered cardiovascular news available through Facebook, Twitter @CardioSmart, and YouTube. For more information about ACC’s social media channels, visit CardioSource.org/ACCinTouch.

BOG and CCA Liaison Elections Coming This Fall

The chance to elect College and Chapter leaders is right around the corner. Board of Governors (BOG) and Cardiac Care Associate (CCA) Liaison elections open Oct. 16 and will close Nov. 13 at 5 p.m. EST. A new addition to the election cycle this year is the presence of guidelines for service as governor. The Governor Nominations Committees are equipped with these new guidelines for selection of the candidates for the position of governor to the domestic states, D.C., Puerto Rico to ensure that the elected official can fulfill his or her duties and uphold the ACC standards of leadership. CCA members can simultaneously place their vote for the next Cardiac Care Associate (CCA) Liaison in their state this fall. Visit CardioSource.org/Elections for more information and details on the election process, or contact National ACC Chapters staff at 202-375-5413.

Cardiology Covers CV Innovation

The newest issue of Cardiology magazine is out and it focuses on the future and innovation in cardiovascular care. The cover story highlights biomarkers, robotics and stem cell therapy. The issue also highlights ACC’s commitment to quality improvement, insights on cardio-metabolic syndrome, background on appropriate use criteria and more. The online issue – also available for iPad and iPhone – features additional video and audio files.

Recent CardioSurve Research All in One Place

The July issue of the CardioSurve newsletter features data from ACC member responses to surveys on the Federal Electronic Health Record Incentive Program, clinical information channels and online resources for cardiovascular professionals, ACC’s Hospital to Home initiative, familial hypercholesterolemia and more. CardioSurve is a voluntary panel of more than 350 domestic cardiologists that respond to monthly surveys from the College.

This Month on ACC in Touch

• ACC President William Zoghbi, MD, FACC reiterates ACC’s commitment to quality and the need for appropriate use in an ACC in Touch Blog piece. The ACC’s message comes after a New York Times piece about overuse of testing and procedures in a Florida health system published on Aug. 6.
• Joseph P. Drozda Jr., MD, FACC, chair of the ACC’s Clinical Quality Committee and a member of the ACC Board of Trustees provides an inside look at “ACC’s Health Policy Statements — One of our Many Faces to the World” as part of a new monthly blog series by the College’s science and quality leaders.
• Medication adherence, or lack thereof, is front and center on the CardioSmart and ACC Facebook pages. Check out the new CardioSmart medication adherence app, as well as other ACC and partner organization resources for both patients and clinicians.
• Weren’t able to go to London for the Olympic Games? < href="https://www.facebook.com/AmericanCollegeofCardiology" target="_blank">ACC’s Facebook page and ACC in Touch Blog ran Olympic-related news and discussions from CardioSource World News and the ACC’s Sport and Exercise Council members.

AHRQ Funding Under Fire in House

The Agency for Healthcare Research and Quality (AHRQ) is de-funded under a spending bill approved on July 18 by the House Labor, Health and Human Services and Education (Labor-HHS) Appropriations Subcommittee. Under the spending bill, AHRQ is eliminated and any patient-centered outcomes research and all economic research within the National Institutes of Health (NIH) is prohibited. At this time, the full House Appropriations Committee has not set a date to act on the bill, and it is uncertain how far it will advance in the House. In the Senate, the Senate Appropriations Committee on June 14 approved $364 million for AHRQ’s base budget.

The ACC has long supported AHRQ and participates in a coalition that advocates for AHRQ funding, the Friends of AHRQ. Earlier this year, the ACC testified before the House Labor-HHS Appropriations Subcommittee about the importance of AHRQ and health services research, among other federal programs. The College signed a Friends of AHRQ "a href="http://www.cardiosource.org/news-media/publications/cardiology-magazine/%257E/media/Files/Advocacy/Prevention%20and%20Research/AHRQ%20HLHHS.ashx" target="_blank">joint letter to the House Appropriations Committee urging them to reject the bill that de-funds AHRQ.

Congress must act on appropriations by the new federal fiscal year on Oct. 1 to continue funding federal agencies. The ACC predicts that Congress will once again resort to enacting a continuing resolution this fall to fund programs into the new year as they have in previous years. Stay tuned to the ACC Advocate enewsletter and CardioSource.org/Advocacy for more information.

ACCF and HRS Release Statement on Pacemaker Device and Mode Selection

A state-of-the-art expert consensus statement focused on pacemaker device and mode selection was recently released by the ACC Foundation and the Heart Rhythm Society. Adult patients with sinus node dysfunction (SND), atrioventricular (AV) conduction block and other less common indications for pacing are the main emphasis. Overall, the statement recommends that patients with SND may benefit from atrial or dual-chamber pacing compared with ventricular pacing in terms of reduced risk of atrial fibrillation (AF), stroke, pacemaker syndrome and improved quality of life. It also suggests that over the long term, dual-chamber pacing may be cost-effective – although at this time costs should not be a dominant factor in determining device and/or mode selection. In patients with AV block, the panel notes that dual-chamber pacing can reduce the incidence of pacemaker syndrome and improve some indexes of quality of life compared to ventricular pacing. Visit CardioSource.org for full coverage.

Complex Coronary Cases Live from Mount Sinai Medical Center

The ACC in July launched its new monthly live case series from Mount Sinai Medical Center’s catheterization lab in New York, NY. During each of the live cases, participants learn how to discuss the rationale for choice of access site in performing percutaneous coronary intervention; detail considerations for stent selection; discuss choice of antiplatelet therapy; and demonstrate the application of large, randomized drug-eluting stent clinical trials results within an interventional clinical practice. Tune into CardioSource.org on the third Tuesday of each month at 8 a.m. ET to watch the latest case live. The cases are also archived at CardioSource.org/MtSinaiCases.

Check Out These Meeting on Demand^TM Programs from July

These and other Meeting on Demand programs are available at CardioSource.org/Meetings-on-Demand: • Championing Care for the Patient with Aortic Stenosis: The Role of Cardiologists and Primary Care from Recognition to Recovery. • Innovation in Translation: Acute Coronary Syndromes • First Line of Defense: Risk Factors and Prevention in the Cardiology Practice - A Master Class for the Community Cardiologist

ACC’s Annual Legislative Conference Just Around the Corner

The 21st Annual Legislative Conference is just around the corner and will kick off with the ACC Political Action Committee (PAC) dinner and remarks from renowned columnist and commentator George Will on Sunday, Sept. 9. Will's speech titled "The Political Argument Today" will be the centerpiece of a fascinating and thought-provoking evening. Monday's sessions will explore a variety of hot topics, including the state of cardiology, pressing legislative and regulatory issues, the 2012 election and the impact of the Supreme Court decision. Attendees will head to Capitol Hill on Tuesday to meet directly with congressional leaders and share ways the cardiovascular community is navigating through rapidly changing environments and striving to provide quality, cost-effective, evidence-based care. In collaboration with WomenHeart, a special congressional briefing on atrial fibrillation and stroke in women will also take place while attendees are on the Hill on Tuesday, Sept. 11.

August JACC President's Page Explains ACC’s Global Outreach

ACC leadership explain the strategy and reasoning behind the College’s heavy global focus in the Journal of the American College of Cardiology (JACC) President’s Page out this month. “The Heart of The Matter: Why the ACC Has an International Outreach,” co-authored by ACC President William A. Zoghbi, MD, FACC, Board of Governors Chair Dipti Itchhaporia, MD, FACC and Immediate Past Chair of International Governors Huon Gray, MD, FACC, answers common questions asked of the College’s global growth strategy. “As the world seems to shrink, there has never been a time of greater opportunity to forge stronger personal and professional relationships, and break down international barriers,” they write. Read the entire piece which also delves into ACC’s work in the areas of twinning, international chapters and global registries.

ACC Document Outlines Impact of Proposed Fee Schedule

The ACC has prepared a detailed document outlining the impacts of the proposed 2013 Medicare Physician Fee Schedule and its impacts on cardiology. In particular the document provides information on proposed cuts included in the rule as part of a new transitional care management code, multiple procedure reductions for cardiology and the fourth year phase-in of the PPIS practice expense survey. Other topics addressed include e-prescribing and Physician Quality Reporting System requirements, value-based purchasing, quality and research use reports and Physician Compare. The final rule will be released in late October.

House Hearing Highlights Registries

The House Ways and Means Health Subcommittee explored physician organization efforts to promote high quality patient care during a hearing in late July. The subcommittee has held a series of hearings examining Medicare physician payment reform ideas and has invited physician organizations at the epicenter of patient care to weigh in on payment approaches that reward quality, efficiency and patient outcomes. Registries were in the spotlight during the hearing and physician groups had the opportunity to demonstrate how data is being used to drive innovation. The ACC testified before the subcommittee on Feb. 7 on several of the exciting quality improvement collaborations underway in cardiology and what lessons can be applied across the health care system to simultaneously reduce unnecessary admissions, readmissions, complications, testing and ineffective spending. Read about where else the ACC has testified in recent weeks including testimony from Past President W. Douglas Weaver, MD, MACC of Michigan and Jerry D. Kennett, MD, FACC of Missouri.

ACC Partners to Promote Wise Care Choices

ACC President William Zoghbi, MD, FACC, was recently interviewed by MedScape about the College's role in the Choosing Wisely® campaign. The ACC, along with eight other specialty societies, are original partners of the campaign, which launched this past April and aims to promote wise choices by clinicians and patients in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions, and reduce the increasingly high cost of health care. Each participating organization, including the ACC, has released evidence-based lists of tests and procedures for patients and physicians to question. Zoghbi talks about the ACC list, in particular, and goes into more details on the College's five recommendations for consumers and providers to question in cardiology.

Partners Unite to Stop Fraud

A new public-private partnership comprised of the federal government, state officials, leading private payers and others aims to prevent health care fraud. Sharing information and best practices is at the core of the new collaborative which utilizes tools made available in the ACA to protect health care dollars. Engaging technology to analyze data and prevent fraud before it occurs is a key component of the initiative's long-range goals. "This partnership is a critical step forward in strengthening our nation's fight against health care fraud," said Attorney General Eric Holder in a statement. "Bringing additional health care industry leaders and experts into this work will allow us to act more quickly and effectively in identifying and stopping fraud schemes, seeking justice for victims, and safeguarding our health care system." View a list of partners and get the details.

New FDA Approvals

The Food and Drug Administration (FDA) in late July approved a new prescription fish oil formulation (Vascepa) for the treatment of high levels of triglycerides. The drug is indicated as an adjunct to diet in adult patients with severe hypertriglyceridemia who are at risk for stroke and heart attack. The drug's triglyceride-lowering efficacy has been studied in both the ANCHOR and MARINE studies. Read more. Also in July, the FDA approved an injection for use in magnetic resonance angiography (MultiHance®) to evaluate patients with renal or aorto-ilio-femoral occlusive vascular disease. The FDA approved a stent system for the treatment of iliac artery disease (Omnilink Elite Vascular Balloon-Expandable Stent System) in early August. To receive immediate FDA-approved cardiovascular drug alerts and related safety information, visit www.ACC.pdr.net.

Decision Reached

The long-awaited U.S. Supreme Court ruling regarding provisions in the Affordable Care Act (ACA) was released on June 28. In a majority decision, the Court ruled that most of the Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. "Now that the decision is behind us, we can continue down the path to health care reform," said ACC President William Zoghbi, MD, FACC. "The ACC favors provisions in the law that supports preventive care, access to care, elimination of waste, and a payment system that encourages quality. Hard work remains ahead before we arrive at a sustainable payment system that emphasizes value and a strong patient-doctor relationship. The ACC remains committed to quality patient care."

What does this mean?

The ACA is the largest expansion of health care coverage since Medicare and Medicaid were initiated in the sixties. The Supreme Court decision means that efforts already underway to implement the law can and will continue. To that end, your ACC will continue to support the policies and provisions with the law that are in line with the College's overarching health care reform principles, including those that expand health care coverage, encourage preventive care, and foster innovative payment and delivery system models that reward quality and ensure value. At the same time, the College will also continue to work with Congress and the Centers for Medicare and Medicaid Services (CMS) on ACA provisions that affect cardiovascular care, including the controversial Independent Payment Advisory Board and CMS implementation of the Physician Payments Sunshine Act. In addition, your ACC will also continue to advocate for fundamental payment and medical liability reforms that were not included in the ACA, but are critical for comprehensive health reform to be truly effective. There are also several regulatory proposals and legislative efforts expected in the coming months that will have major impacts on cardiology. Get the details.

FDA News

On Tuesday, the Senate voted to extend the Food and Drug Administration (FDA) User Fee Act in a vote of 92 to 4. It passed in the House last week by voice vote and is expected to head to the president's desk for his signature before the July 4 recess. "Quickly getting the latest devices and prescription drugs to patients who need them is critical to our nation's health," said Zoghbi, following the news. "Members of the House and Senate demonstrated that they can come together in a bipartisan way to approve a measure that will support innovation and safety in health care." Read the article.

The FDA also:

• Recently followed an advisory panel recommendation and rejected rivaroxaban for treatment in patients with acute coronary syndrome. In May, concerns over the ATLAS ACS 2 TIMI trial, including its design and execution and missing data, were raised during a day-long meeting of the Cardiovascular and Renal Drugs Advisory Committee. Rivaroxaban was approved for the prevention of stroke in nonvalvular atrial fibrillation late last year and is also approved for preventing deep vein thrombosis after knee or hip replacement surgery. Learn more.
• Requested additional information from the manufacturers of apixaban, a factor Xa inhibitor, for the prevention of stroke in patients with atrial fibrillation. The agency has not requested additional trials, but would like further clarification from the ARISTOTLE trial that investigated the efficacy of apixaban versus warfarin in these patients.
• Approved the obesity drug lorcaserin, the first prescription weight-loss pill to be approved in the last decade. Earlier this year, an FDA advisory panel endorsed a similar drug (Qnexa) and a final FDA decision is expected around July 17.

Stay up-to-date on the latest FDA news on CardioSource.org or follow @Cardiology on Twitter.

FDA Hearing TAVR News

Last month, the U.S. Food and Drug Administration’s (FDA’s) Circulatory System Devices Panel of the Medical Devices Advisory Committee voted 11 -0 with one abstention in favor of expanding indications for use of the Edwards SAPIEN™ Transcatheter Heart Valve to include patients eligible but at high risk for aortic valve surgery and the transapical approach.

The Sapien system was previously approved last November for patients who are not considered surgical candidates for aortic valve replacement. The advisory panel’s decision follows a day-long hearing that included testimonies from representatives from the ACC, The Society of Thoracic Surgeons (STS), Edwards Lifesciences, the FDA, patients and physicians.

John Carroll, MD, FACC, from the University of Colorado, Denver, and a member of STS/ACC Transcatheter Valve Therapy (TVT) Registry Steering Committee, testified on the College’s behalf. His testimony focused on how registries like the STS/ACC TVT Registry can be leveraged to evaluate patient selection, procedure indications, peri-procedural outcomes and longitudinal safety surveillance and patient outcomes. He also discussed the benefits to using a clinical registry for post-market surveillance and specifically using the recently created TVT Registry for post approval studies, which include:

• Ability to focus on previously identified critical issues
• Development of risk models tailored for the TVT population
• Tracking of long-term and quality of life outcomes
• Decision-making tools for patients, families, clinicians and regulators
• Appropriateness of care
• Potential expansion of indications for use

Carroll followed a presentation from Jeffrey Rich, MD, FACC, president of STS, on the collaboration of cardiologists and surgeons in bringing transcatheter aortic valve replacement (TAVR) to the American population.

It is now up to the FDA to make a final decision. View exclusive video coverage of the meeting. Read the ACC's complete written testimony here.

New Appropriate Use Criteria Released

The ACC, in partnership with 10 other leading professional societies, recently released new appropriate use criteria (AUC) focused on peripheral vascular ultrasound and physiological testing. This newest set of AUC focuses on a total of 255 indications (with the inclusion of surveillance timeframes) where ultrasound and physiological testing is frequently considered. In addition to looking at the reasons for ordering these tests, they also focus on how frequently repeat testing is needed in clinical practice in light of the need for ongoing surveillance in some patients. The AUC also outline key areas for research moving forward. A related report presenting AUC for vascular laboratory testing to evaluate venous circulation is expected to be released in late fall of this year. Share your thoughts on the newest criteria in the ACC in Touch Blog.

Weigh in…

CMS is requesting stakeholder review and public comment of the recently developed hospital quality measure of acute myocardial infarction (AMI) mortality for use with EHR data, a measure that was developed in partnership with Yale New Haven Health Services Corporation/Center for Outcomes Research and Evaluation. CMS developed and has implemented an AMI 30-day risk-standardized mortality measure using CMS claims data since 2008. The measure, designed for potential use in public reporting in the EHR environment, has undergone eSpecification and its related testing will be completed later in 2012. Find out how to submit feedback ahead of the July 14 deadline.

What's appropriate in imaging after all?

Cardiovascular Imaging Strategies, a product of the ACC's Imaging in FOCUS initiative, is being used by two regional health plans and active discussions are underway with health plans and employers in 10 additional states. The product offers local ACC Chapters an opportunity to work with health plans on appropriate use, as a part of payment reform and/or an alternative to radiology benefit managers. Built upon ACC core competencies, Cardiovascular Imaging Strategies uses clinical decision support to assess the appropriateness of patient selection for cardiac imaging. These patterns are then used to engage practices and referring physicians in action planning and quality improvement. The product also offers QI credit for lab accreditation and MOC Part IV credit for physicians. This result is a performance-based, transparent and accountable solution to encourage appropriate imaging and understand exceptions to the standards. To date, AUC imaging standards exist for cardiac radionuclide imaging, cardiac computed tomography, cardiac magnetic resonance imaging, echocardiography and diagnostic cath. Learn more. Later this summer, a similar product will be made available directly to practices. Also, check out a special AUC series on the ACC in Touch Blog to browse through a variety of perspectives on appropriate use and leave a comment.

Cardiac Rhythm Management Clinical Community

The ACC, in partnership with the Heart Rhythm Society, has introduced a new clinical Community on CardioSource.org focused on topics that the general cardiologist needs to know about rhythm disturbances, including the appropriate use of devices in the management of rhythm issues. The community’s ultimate goals are to provide resources and information to help facilitate a dialogue in relevant patient cases and increase shared decision making effectiveness. Learn more.

New AUC for Peripheral Vascular Ultrasound and Physiological Testing Released

The ACC Foundation (ACCF), in partnership with 10 other leading professional societies, released new appropriate use criteria (AUC) focused on peripheral vascular ultrasound and physiological testing on June 11.

“This is the first systematic and comprehensive evaluation looking at appropriate indications for vascular testing, such as ultrasound or functional testing,” said Emile R. Mohler III, MD, FACC, director of vascular medicine for the University of Pennsylvania Health System and chair of the writing committee.

This newest set of AUC focuses on 159 indications where ultrasound and physiological testing is frequently considered. In addition to looking at the reasons for ordering these tests, the work group also sought to determine how frequently repeat testing is needed in clinical practice in light of the need for ongoing surveillance in some patients. Of the 159 scenarios, 117 were rated as appropriate, 84 were rated as uncertain, and 54 were rated as inappropriate. The document also outlines key areas for research moving forward. A related report presenting AUC for vascular laboratory testing to evaluate venous circulation is expected to be released in late fall of this year.

ACC President to Represent ACC and CardioSmart in the Olympic Torch Relay

ACC President William Zoghbi, MD, FACC, was chosen by the Coca-Cola Company to represent the College and CardioSmart in the Olympic Torch Relay leading up to the 2012 Summer Olympics in London. The relay, which takes place over 70 days, began May 19 and will include 8,000 torch bearers who will run through more than 1,000 cities, towns and villages in the UK, leading up the Olympic Opening Ceremony on July 27. Zoghbi is one of 22 participants chosen to carry the Olympic Flame, which will take him through Bicester, England on July 9. Other participants chosen by Coca-Cola include leaders of national health organizations, former Olympians including Michelle Kwan and Summer Sanders, and young people representing charitable organizations. Participants were selected due to their commitment to live positively and make a difference in their communities. Said Zoghbi in an ACC In Touch Blog post: “It is truly an honor to be part of this historical event, which brings together people from around the world in the spirit of competition.” Read the full post.

Be and Insider with the ACC In Touch Blog

Each week on the ACC in Touch Blog, ACC President William Zoghbi, MD, FACC, BOG Chair Dipti Itchhaporia, MD, FACC, and other College leaders share their perspectives on the latest hot topics in cardiovascular care, health policy and more. New this year, in addition to providing a discussion forum on various issues facing cardiology, Zoghbi is also using the blog to provide members with a first-hand glimpse into the meetings, trips and other engagements that the ACC leadership team is undertaking on their behalf. Members can subscribe to receive e-mail updates when new posts are added directly from the ACC in Touch Blog site and/or add the RSS feed to your RSS reader.

ACC Testifies Before FDA on ASD Closure Devices

The ACC recently provided testimony, as well as a written statement, on the safety of atrial septal defect (ASD) closure devices before an FDA Circulatory Systems Devices panel meeting. ASDs, which can eventually contribute to significant morbidity and mortality if left untreated, currently represent approximately 10 percent of congenital heart defects. ACC representative John Moore, MD, FACC, a member of the IMPACT® Registry Steering Committee, urged the FDA to consider a prospective study of potential risk factors for erosion in relation to the implantation of ASD occlusion devices and that the NCDR® provide the infrastructure for that study. Furthermore, he advocated for an FDA-funded registry study to assess adverse events in patients with implanted devices after discharge to better ascertain if and when problems occur. Visit the FDA issue center on CardioSource.org to keep up-to-date on FDA updates and ACC action.

FDA User Fee Legislation Moving Through Congress

The House and Senate in late May passed overwhelmingly passed their respective bills (H.R. 5651 and S. 3187) to reauthorize user fees collected by the FDA from medical device and pharmaceutical companies to fund the approval process. Over the next month, Committee staff from both chambers will work together to iron out differences between the bills before voting on final legislation and sending to the president for his signature. "The ACC supports Congress's decision to reauthorize FDA's user fees for devices and prescription drugs. Appropriate funding allows the FDA to provide oversight and to review and approve new treatments in a timely manner," said ACC President William Zoghbi, MD, FACC, in a statement. Read the complete article.

Follow-up on TAVR NCD

The Centers for Medicare and Medicaid Services (CMS) announced approval of a National Coverage Determination (NCD) of transcatheter aortic valve replacement (TAVR). Your ACC has put together two documents to help you understand the NCD. Read the ACC's summary and analysis and check out the TAVR coding guide. Meanwhile, the FDA will be considering expansion of the label indication for the Edwards Sapien Valve to include the transapical approach and high-risk surgical candidates on June 13. John Carroll, MD, FACC will present before the panel.

Payer Advocacy in Action

The ACC and the Heart Rhythm Society (HRS) met with Aetna and its pre-authorization vendors, Carecore and MedSolutions, to discuss concerns regarding the upcoming Cardiac Rhythm Implant Pre-Authorization program and their clinical criteria. Beginning June 1, Aetna will require all elective ICD, pacemaker, and CRT device implantations to be pre-authorized through Carecore (New York and New Jersey) or MedSolutions (all other Aetna markets). During the meeting, ACC and HRS highlighted the importance of following the ACC/HRS Practice Guidelines as well as reducing the level of administrative burden. Both vendors encouraged providers to utilize their web portals for entering requests and instant decisions. Contact advocate@acc.org for more information.

The Countdown Begins for E-Prescribing Participation

The beginning of June signals that the deadline for E-Prescribing Incentive Program hardship exemption applications is approaching. Those who were unable to electronically prescribe due to local, state, or federal law, or regulation; have or will prescribe fewer than 100 prescriptions during a six-month reporting period (Jan. 1 – June 30); practice in a rural area without sufficient high-speed Internet access; or practice in an area without sufficient available pharmacies for e-prescribing, may qualify. Hardship exemptions must be submitted through the Quality Reporting Communication Support Page no later than June 30. For those already participating in the program, the Agency for Healthcare Research and Quality's recently released two new implementation toolsets for e-prescribing targeted at private practices and pharmacies.

Version 5010 Deadline June 30

As part of the transition to ICD-10 code sets, health care providers that electronically submit administrative transactions (such as checking a patient's eligibility, filing a claim, or receiving a remittance advice) either directly to a health insurance payer or through a clearinghouse, were required to switch to new HIPAA standards, called Version 5010, as of Jan. 1, 2012. Providers needed to have the necessary software and system changes in place by the deadline in order to continue sending and receiving HIPAA electronic transactions. The Centers for Medicare and Medicaid Services (CMS) earlier this year extended enforcement of this requirement until June 30. ACC members are strongly encouraged to ensure their systems are in compliance by this new date. To ensure unnecessary rejections of Version 5010 claims, don't forget to include a 9-digit ZIP code; a physical billing provider address (not a PO Box); and your National Provider Identifier (Tax IDs and Social Security Numbers will not be accepted).

A Look at Health Care Cost Control

During an Alliance for Health Reform event, ACC's Senior Vice President of Advocacy James Fasules, MD, FACC, sat on a panel of experts that examined the role of technology and chronic conditions on rising health care costs. Fasules took the opportunity to discuss how the ACC is striving for quality improvement and cost reduction through quality programs, including H2H, Imaging in FOCUS and PINNACLE; guidelines and appropriate use criteria; appropriate use of technology; and involvement in the Choosing Wisely Campaign.

Where Will You Be in September?

Registration for the 2012 Legislative Conference in Washington, D.C. is now open! This year is sure to be exciting with the impending Supreme Court decision on health care reform and the upcoming presidential election. The conference is a unique opportunity to hear first-hand from members of Congress, Capitol Hill staff and other policymakers who will provide an insider's view from the Hill. This is also a chance to meet one-on-one with congressional leaders to share how their decisions are impacting your practice. Get the details and register at CardioSource.org/LegislativeConference.

Cardiology Focuses on CHD

The new May/June issue of Cardiology magazine offers a focused look at congenital heart disease (CHD), from the ACC's Adult Congenital and Pediatric Cardiology Council and Section advocacy and Chapter efforts, to a closer look at the future needs of the rapidly growing adult CHD community. The issue also highlights the latest clinical documents, ACC activities around the world and important advocacy and practice management updates. The online issue – also available for the iPad and iPhone – features additional video and audio files. Readers can also listen to sample audio interviews from ACCEL, the ACC's audio journal about the diagnosis and treatment of cardiovascular disease. Read the issue online or download the iPad app.

Member Center Integrated With “My CardioSource”

After a recent business system upgrade, the ACC is offering improved services from the Member Center, which is now fully integrated with “My CardioSource.” Members will now be able to easier access:

• A more robust member database.
• Information about your CME/CE/MOC status.
• Purchasing products, registering for programs and paying dues.

Members can also track purchases and payments with a convenient shopping cart located in the upper right hand corner of the site. For those who previously bookmarked the old Member Center, visit CardioSource.org, scroll over “ACC” and select “Member Center” to access the new link. Or enter http://www.cardiosource.org/My-Cardiosource/My-Profile.aspx into your browser.

Contact the Resource Center with any questions at:

ACC Resource Center: Available Monday-Friday, 9 a.m.-5 p.m. EST
Phone: (202) 375-6000, ext. 5603 or (800) 253-4636, ext. 5603
Fax: (202) 375-7000
E-mail: resource@acc.org

ACC, ACP Collaborate on New PINNACLE Registry Pilot for Primary Care

The ACC and the American College of Physicians (ACP) have announced plans to launch a pilot program, PINNACLE Primary Care, that will expand the PINNACLE Registry to assess performance measures for primary care practices. The new program, which will be known as PINNACLE-PC, will measure performance on breast and colon cancer screenings, influenza and pneumonia immunizations, lower back pain, diabetes, depression, weight management, and chronic obstructive pulmonary disease.

“Registries are excellent quality improvement tools,” said ACC President Dr. William Zoghbi, MD, FACC. “Registry participants receive quick feedback that can help practices ensure that they are providing consistent, evidence-based care. Expanding the PINNACLE Registry to include primary care is a natural extension of this great resource, which will ultimately improve care.”

“We are very enthusiastic about our collaboration with ACC and this program to test the PINNACLE Registry in primary care internal medicine practices,” said ACP President David L. Bronson, MD, FACP.

Expanding PINNACLE to primary care has been a goal for the registry since its inception. The pilot will begin this summer with five to 10 internal medicine practices. Data from pilot practices will be collected through December 2012 and results will be analyzed in early 2013. If the pilot is successful, the PINNACLE Registry will be made available to ACP members.

The PINNACLE registry already assists practices in understanding and improving care through the production and distribution of quarterly performance reports for data-submitting practices and physicians. The reports cover all valid patient encounters and detail adherence to 25 cardiovascular clinical measures at the physician, location, and practice levels across the diagnoses of coronary artery disease, hypertension, heart failure, and atrial fibrillation. Thirteen additional performance measures will be added to PINNACLE to create PINNACLE-PC.

Policy Statement Focuses on Patient-Centered Care

The concept of patient-centered care (PCC) is an increasingly hot topic in the ongoing discourse surrounding quality improvement. In an effort to shed light on the current state of PCC as it pertains to cardiovascular medicine, as well as provide a roadmap for future PCC efforts, the ACC Foundation (ACCF) released a special PCC-focused health policy statement on May 14. Developed by a writing committee made up of a wide range of representatives from general medicine, the cardiac care team, consumers, and advocacy, the new document is an outgrowth of the ACCF's commitment to develop a patient-centered approach to cardiovascular care, which began in 2009. The paper highlights the enhance elements that are key to PCC care including clinician/patient communications, health literacy, clinician-directed patient education and shared decision-making.

The document urges focused education and training around patient-clinician communications as part of medical school and continuing education curricula, as well as clinician access to (and knowledge of) patient education materials that meet a variety of cultural and/or learning needs and acknowledge patients as respected partners in their care. The statement also stresses the need to develop a patient-centered medical home for cardiovascular care that demonstrates the ability to manage patients with advanced cardiac disease across care settings, as well as the importance of accumulating and sharing information across all encounters of a single patient to the greatest extent possible, with the ultimate goal of improving chronic disease management. Looking to the future, the statement touches briefly on the increasing use of personalized medicine and the need for patients to have “clear and realistic understandings of therapeutic options” in order for it to be sustainable. It also calls for the empowerment of non-physician members of the care team to provide PCC and help manage the increasing demands of patients with chronic heart disease. Read the complete article, which includes additional ACC in Touch Blog post from President William Zoghbi, MD, FACC, and video coverage, on CardioSource.org.

New Appropriate Use Criteria for Diagnostic Catheterization Released; Update on Cath Lab Standards

The American College of Cardiology Foundation (ACCF) and the Society for Cardiovascular Angiography and Interventions (SCAI) on May 9 released Appropriate Use Criteria (AUC) for Diagnostic Catheterization. The criteria, which look to help clinicians determine when cardiac catheterization is a reasonable option for the evaluation of patients for heart disease, are the newest addition to the growing list of AUC documents. The AUC for diagnostic catheterization were developed by a technical panel that identified 166 possible clinical scenarios when referral for diagnostic catheterization might be considered. The appropriateness of these scenarios, which were drawn from the medical literature and anticipated clinical applications, were then assessed and rated as either "appropriate," "inappropriate" or "uncertain." Read more about the criteria. Up next are Appropriate Use Criteria for Peripheral Vascular Ultrasound and Physiological Testing. “Part one” of the criteria will publish online in early June. Stay tuned to the “Appropriate Use Criteria” issue center under CardioSource.org/Advocacy.

ACCF, SCAI Publish New Standards Defining Best Practices for Modern Cardiac Cath Labs

The ACCF and SCAI have released an updated expert consensus document offering physicians guidance and also including specific recommendations on setting up, operating and maintaining the highest standards of quality in a contemporary cardiac catheterization laboratory. The document, which updates a similar document released in 2001, includes a shift in focus from diagnostic tests to catheter-based therapies, from coronary disease alone to include the treatment of valvular heart disease, congenital defects of the heart and arterial disease in the legs, brain, and other organs. An increasing number of medical centers are developing hybrid cath labs that combine all the features of a surgical suite with those of a cath lab. And pediatric cath labs—now devoted almost exclusively to therapy—apply minimally invasive catheter techniques to congenital disease that once required major heart surgery, with procedures now being performed on unborn fetuses and newborns, as well as older children. Learn more about the consensus statement.

CMS Releases Official National Coverage Determination of TAVR

The Centers for Medicare and Medicaid (CMS) on May 1 finalized its National Coverage Determination (NCD) for Transcatheter Aortic Valve Replacement Therapy (TAVR). Under the final NCD, TAVR will be covered when performed with an FDA-approved device consistent with labeled indications and any other FDA requirements. The determination also states that Medicare will only cover facilities meeting certain requirements and that all patients must be included in a national TAVR registry. The ACC/STS TVT Registry, which has been designed to meet the NCD's registry participation requirement, is up and running and enrolling TAVR facilities now. Non-FDA-approved indications will receive Medicare coverage when performed in a CMS-approved clinical study. "The ACC hopes this NCD proves to be a successful model for providing rapid access to promising new technologies for Medicare beneficiaries while focusing on patient safety, quality care and outcome," said ACC President William Zoghbi, MD, FACC. Read more about what is covered in the NCD and explore the TVT Resource Center for the latest news and clinical documents on this transformative technology. You can also read learn more about TAVR with a new ACC Foundation Meeting on Demand program.

E-Prescribing deadline is June 30!

CMS has developed a support page to help providers with Medicare e-prescribing payment adjustment hardship exemption requests. Medicare Part B Physician Fee Schedule payment adjustments are underway for those eligible professionals who did not initiate e-prescribing in 2011. Penalties of one percent kicked-in Jan.1 and will increase to two percent by the end of 2014 for providers who fail to comply. However, if you did not e-prescribe in 2011 and qualify for a hardship exemption, you can avoid the 2013 payment adjustment by meeting a set of reporting requirements by June 30. Visit the Health IT Issue Center on CardioSource.org for additional information. Also be sure to check the ACC in Touch Blog every Thursday throughout the month of May for tips "from the field" and expert advice on how to avoid health IT-related penalties and benefit from both the e-prescribing and electronic health record incentive programs.

Hospital payment rates likely to increase

Under the recently released 2013 Hospital Inpatient Prospective Payment System proposed rule, which covers payment and quality issues for services provided to patients admitted into the hospital, payment rates to hospitals will increase by 2.3 percent. The rule states that the introduction of surgical site infections following cardiac implantable device procedures will be classified as a "hospital-acquired condition" and the hospital will not be eligible for higher payments resulting from the complication in conditions. As part of the Affordable Care Act, the rule establishes penalties for hospitals with high readmission rates for patients with acute myocardial infarction, heart failure and pneumonia. A performance measure for statins prescribed at discharge has also been added as part of the hospital value based payment program that adjusts payment based on the quality of care provided in the hospital setting. Stay tuned for ACC's comments on the proposal after additional analysis is completed.

Provider Enrollment Update

Under CMS' recent final provider enrollment rule, specialists are exempt from recent changes to provider enrollment standards. The rule calls for providers and suppliers to include their National Provider Identifier (NPI) on all Medicare and Medicaid enrollment applications, but exempts specialists since Medicare beneficiaries are not required to have a referral to see a specialist. Additionally, the rule says that residents can enroll in Medicare in states where they are licensed to practice and order treatments; however, teaching physicians will be required to include an NPI in states where residents are not licensed. To learn more about the changes, click here. Meanwhile, to accommodate the new requirements for tracking NPIs of referring and ordering physicians, the ACC anticipates changes to the CMS-1500 form within the next year. The College is monitoring these developments, but urges providers to consult with their practice management system vendors to ensure systems are up-to-date. Also of important note, the Internet-based PECOS (Provider Enrollment, Chain, and Ownership System) now allows providers to sign Medicare enrollment applications electronically. Once an application is submitted, providers will receive an email from "customerservice-donotreply@cms.hhs.gov" with additional instructions.

New Heart Failure (HF) Performance Measures Released

Updated performance measures for adults with HF were recently released by the ACC, in collaboration with the American Heart Association and the American Medical Association-Physician Consortium for Performance Improvement. The updated 2011 measures, which include care provided in both inpatient and outpatient settings, emphasize the need to measure quality of care over time and across providers, while also focusing on functional outcomes. Of note is the expansion of the beta-blocker measure to the inpatient, as well as the conversion of the measure on patient education to a quality metric, which should be used for internal quality improvement purposes only, not public reporting. Find out what other updates are included and take advantage of ACC resources, including the Heart Failure Practice Solutions Toolkit, that are designed to help put HF guidelines and performance measures into practice. In addition, the Hospital to Home (H2H) Initiative led by the ACC and the Institute for Healthcare Improvement is another important resource for hospitals and cardiovascular care providers interested in improving transitions from hospital to “home,” and more importantly avoiding any federal penalties associated with high readmissions rates.

ICD-10 Deadline Fast Approaching

The deadline for upgrading to Version 5010 is June 30 and CMS is urging all HIPPA covered entities to complete the transition as soon as possible to avoid any issues that may arise with claims processing or payment. If you are still working to implement Version 5010, this CMS fact sheet is helpful for troubleshooting common difficulties. For additional information on the upgrade, visit CardioSource.org/ICD10.

The ACC weighs in on "Meaningful Use" Stage 2

Formal comments on the proposed rule for Stage 2 of the Electronic Health Record (EHR) Incentive Program were submitted to the Centers for Medicare and Medicaid Services (CMS) in early May. From the ACC's standpoint, the Stage 2 requirements "set the bar for success too high" and there is concern that providers and vendors may not be able to address the requirements before 2014. According to the comment letter, "The Meaningful Use criteria should encourage the appropriate, purposeful and accurate use of EHR solutions, rather than mandate completion of tasks based on a particular timeline." Find out what else the College included in its comments and read an ACC in Touch Blog post by ACC BOG Chair Dipti Itchhaporia, MD, FACC, on the subject. The ACC in Touch Blog is featuring a special series on health IT every Thursday throughout the month of May.

Physician Payments Sunshine Act Delay

Drug and medical device companies will not have to start collecting data on their payments to physicians until 2013. According to CMS, the implementation date was pushed back "in order to provide time for organizations to prepare for data submission and to sufficiently address the important input we received during the rulemaking process." A proposed rule for the act, part of the Affordable Care Act, was issued in December and a final rule is expected later in 2012. Read more about the ACC's initial input on the regulations and comments on the proposed rule.

ACC Voices Concern on FDA Action

The ACC recently voiced its concern on the FDA's proposal to remove prescription requirements from cardiovascular-related conditions, such as hyperlipidemia and hypertension. In a formal comment letter, the ACC noted that removing these requirements makes it difficult to monitor patients and ensure their safety and stressed that physicians be involved in these care decisions. The College also submitted comments to the Circulatory System Devices Panel of Medical Devices Advisory Committee regarding the safety of atrial septal defect (ASD) occlusion devices. Given the insufficient data on the potential risk factors for erosion and frequency of adverse events associated with the devices, the ACC recommended using the National Cardiovascular Data Registry (NCDR) to study the potential risk factors. The letter also suggested an FDA-funded study that tracks patients with implanted devices after discharge to assess adverse events. A public meeting on the subject is taking place on May 24 and John Moore, MD, FACC, will be speaking on the College's behalf. Read more FDA updates in the FDA Issues Center.

New Clinical Community Addresses Cardiac Rhythm Management

The ACC, in partnership with the Heart Rhythm Society, has introduced a new clinical community on CardioSource focused on Cardiac Rhythm Management. The community addresses topics that the general cardiologist needs to know about rhythm disturbances, including the appropriate use of devices in the management of rhythm issues, as well as other rhythm-related issues. The ultimate goals are to provide resources and information to help facilitate a dialogue in relevant patient cases and increase shared decision making effectiveness. Learn more at: http://crm.cardiosource.org.

Zoghbi to Focus on Patient-Centered Care During His Presidential Year
The ACC's 61st Annual Convocation welcomed more than 250 new Fellows and more than 20 new Associates on the last night of ACC.12 in Chicago. The evening also brought with it the installation of William Zoghbi, MD, FACC, as the new ACC president. Zoghbi, a leader in the field of cardiovascular imaging and echocardiography, is the William L. Winters endowed Chair of Cardiovascular Imaging at The Methodist DeBakey Heart and Vascular Center and director of the Cardiovascular Imaging Institute at the Methodist Hospital in Houston, Texas. During his acceptance address, Zoghbi told new Fellows and AACC's that they are being inducted at a time when the field of Cardiology is exciting, yet challenging. "Our capacity to diagnose and treat heart disease has never been greater. Yet, the sobering fact is that heart and vascular disease remain the leading cause of death around the globe," he said. "Equally sobering," he added, "the current American health care system is not sustainable. As a result of these factors, Zogbhi said, the thematic focus of his presidential year will be patient-centered care, a style of care that emphasizes educating and involving patients in medical decision making; integrating medical care, and applying principles of disease prevention and behavioral change. Read a CardioSourceNews interview with Zoghbi, here.  For complete news from ACC.12, click here.

Earn Additional CME with iScience MOD
ACC.12 and ACC-i2 with TCT are not over just because attendees have left Chicago. The digital presentation library of iScience includes more than 400 hours of meeting on demand (MOD) educational content presented during the meeting, including synchronized audio and presentation slides. Users can begin earning up to 100 additional CME credits within 24 hours of purchase with online access. iScience features downloadable audio files and streaming content for iPad and iPhone. Offline users can access the same content available online with the portable, compact drive. Meeting attendees can order iScience with their registration badge number or the promo code “ACC.12 Flyer” atwww.CMEonCall.com/ACC. 

Campaign Seeks To Reduce Unnecessary Medical Procedures
The ACC has released a list of "Five Things Physicians and Patients Should Question" in cardiology as part of the Choosing Wisely campaign, led by the ABIM Foundation with eight other medical specialty societies. The list identifies five targeted, evidence-based recommendations to support physicians and patients in making wise choices about their care. The ACC's list was developed over the last several months, with the College asking its standing clinical councils to recommend between three and five procedures that should not be performed or should be performed more rarely and only in specific circumstances. ACC staff took the councils' recommendations and compared them to the ACC's existing appropriate use criteria (AUC) and guidelines, choosing items for the five things list that had the tightest inappropriate score in the AUCs and were Class III recommendations in the guidelines. The ACC's Advocacy Steering Committee and Clinical Quality Committee each then reviewed the five items before sending it to the ACC Executive Committee for final review and approval. Read more, including the ACC’s recommendations, in an ACC in Touch Blog post. Also learn more about Choosing Wisely and read the lists at www.ChoosingWisely.org.

VIDEO: April ACC Update Looks Back at ACC.12
The April edition of the ACC Update features an interview with new ACC Board of Governors Chair Dipti Itchhaporia, MD, FACC, where she discusses what her focus for the College will be during her upcoming year. The update also highlights the recent ACC.12 and ACC-i2 with TCT meeting in Chicago, including coverage of the inauguration of new ACC President, William Zoghbi, MD, FACC, who said one of his main goals will be to enhance the College’s focus on patient-centered care. View the entire update.

Quality Improvement Ad Series Launched
This month the College launched a series of three print advertisements that will appear in ACC publications including Cardiology magazine. The series was created with the hopes of reinforcing the unparalleled work and advancements that cardiologists and cardiovascular professionals have made in the last few decades. The ads focus on the reduction of morbidity and mortality, readmissions and door-to-balloon time. View the series here.

New Expert Consensus Document Addresses Operator and Institutional Requirements for TAVR
On March 1 the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), the American Association for Thoracic Surgery (AATS), and the Society of Thoracic Surgeons (STS), released a Multisociety Expert Consensus Statement for Operator and Institutional requirements for Transcatheter Valve Repair and Replacement.

The recommendations in the statement classify operating requirements for both existing TAVR centers and those that intend to develop a TAVR program, credentialing requirements for cardiac surgeons and interventional cardiologists who perform the procedure, and guidance for maintaining approval to perform TAVR.  Requirements include:

• Annual heart (aortic valve) surgery and interventional procedural volume requirements for institutions
• Board certification and procedural requirements for both surgeons and interventional cardiologists
• Participation in FDA-approved clinical trials post-approval studies
• Monitoring of complication rates and institutional follow up
• Participation in national databases for continued tracking of outcomes
• Commitment to a heart team concept that is led by the surgeon and interventional cardiologist and made up of a formal collaborative effort among all medical team members. In all aortic procedures, the interventional cardiologist and surgeon must both be present during the entire procedure ensuring joint participation and optimal patient-centered care.

FDA Alert! The FDA has approved safety label changes for statins, which include eliminating the requirement for routine monitoring of liver enzymes from the drug labels and adding information about the potential for generally non-serious and reversible cognitive side effects and reports of increased blood sugar and HbA1c levels. Also, the label for lovastatin has been updated with new contraindications and dose limitations when it is taken with certain medicines that can increase the risk for muscle injury. Health care professionals should follow the recommendations in the lovastatin label regarding drugs that may increase the risk of myopathy/rhabdomyolysis when used with lovastatin. The FDA continues to recommend health care professionals perform liver enzyme tests before initiating statin therapy in patients and as clinically indicated thereafter. Read more.

New FDA Partnership
The ACC is partnering with the FDA on a new pilot program, the Network of Experts. In an effort to draw upon the breadth and depth of expertise of outside experts, the FDA's Center for Devices and Radiological Health (CDRH) is developing relationships with organizations such as the ACC that have access to individuals with a wide range of expertise. Through these relationships, ACC members will be able to assist FDA personnel reviewing applications submitted by device manufacturers. How it works: The FDA will notify ACC when reviewers have questions for outside experts and the general topic of those questions. At that time, the ACC will contact individuals who have agreed to participate in the Network of Experts and alert them, based on their areas of expertise, of the request. Individuals will have a short window of time in which to let ACC know of their availability to assist the FDA and to complete a short conflict of interest form. If you are interested in joining the Network of Experts, click here to notify ACC of your interest and to answer a few additional questions that will assist ACC in properly directing FDA inquiries at the appropriate time.

Next up for Health IT
CMS has issued its long-awaited proposed rule outlining the criteria necessary for providers to meet Stage 2 of the federal Electronic Health Record (EHR) Incentive Program. The rule makes minor changes to Stage 1 requirements for those who begin participating in the program in 2013 and delays Stage 2 implementation until 2014. It also would increase the number of core objectives practitioners must meet from 10 to 17 and require practitioners to meet three out of five menu objectives. In addition, it would allow for the electronic reporting of clinical quality measure data and set the requirements for avoiding the statutorily-mandated penalties beginning in 2015. It was also encouraging to see that CMS has included reporting to specialized registries as one of the proposed menu-set objectives. The College will submit formal comments within the 60-day comment period window. The College is preparing detailed comments for submission within the 60-day comment period. Read more. For ACC resources on health IT go to CardioSource.org/HealthIT. Also, check out the following page for special health IT sessions and activities at ACC.12.

ICD-10 Update
The Department of Health and Human Services has issued a proposed rule delaying the Oct. 1, 2013 ICD-10 transition deadline for one year. The transition will require a move from 17,000 diagnosis and procedure codes to more than 155,000 and providers, along with several medical specialty societies, have expressed concerns about accomplishing all of the system upgrades and testing under the current timeline. The ACC urges members to continue to prepare for the transition. In particular, if you have not completed the upgrade to Version 5010 this needs to be completed as soon as possible. The deadline for Version 5010 upgrades was extended from Jan. 1 to June 30. Visit CardioSource.org/ICD10 for ACC resources and links to CMS tools.

Medicare enrollment changes
CMS has announced improvements to its web-based provider enrollment system, known as PECOS, in an effort to reduce the administrative burden on physicians and other practitioners who provide services to Medicare patients. One of the biggest improvements is the addition of electronic signatures, which eliminates the need to mail a separate signature page to Medicare contractors in addition to filling out the online enrollment application. Other beneficial changes include the ability to access additional information, such as whether a request for revalidation has been sent to you by your contractor and previously used address information. Also, applications returned for correction can be easily corrected and resubmitted promptly. For those unfamiliar with Internet-based PECOS, visit the CMS website to learn more. If you prefer to use the paper enrollment applications, be certain that you are using the most recent version of the forms.

Health Reform “Springs” Into Spotlight
With March 23 marking the two-year anniversary of the Accountable Care Act (ACA), the House of Representatives vote to repeal the controversial Independent Payment Advisory Board provision in the ACA, the ongoing divisive budget discussions that all plan to drastically cut Medicare and Medicaid spending, and the Supreme Court hearing six hours of oral arguments on the constitutionality of the law from March 26-28, health care reform continues to be in the spotlight. No matter what happens with Congressional politics and the Supreme Court, the American College of Cardiology (ACC) continues to be committed to setting a new standard for health care delivery in a way that is centered on increasing the quality of care and ensuring greater patient value. Read more on the ACA and the ACC’s health reform agenda here.

 

FDA Approves SAPIEN Transcatheter Heart Valve
The Food and Drug Administration (FDA) has announced approval of the Edwards Lifesciences SAPIEN Transcatheter Heart Valve. This is one of several devices in development for use in the emerging field of transcatheter aortic valve replacement (TAVR). In announcing the decision, the FDA also noted that Edwards Lifescience will continue to evaluate the outcomes of the SAPIEN transcatheter heart valve through a national Transcatheter Valve Therapy (TVT) Registry that will track patient safety and real world outcomes related to emerging TAVR procedures. The American College of Cardiology and the Society of Thoracic Surgeons have been working with the FDA and the Centers for Medicare and Medicaid Services in the development of this new registry, called the TVT RegistryTM, which is scheduled to launch in late 2011. It will be the first national program to evaluate safety and efficacy of a TAVR option for patients who are otherwise considered to be high-risk or non-operable for conventional valve replacement surgery. For more on the announcement and what this means for TAVR, click here.

2012 Physician Fee Schedule Final Rule Released
The Centers for Medicare and Medicaid Services released the final 2012 Medicare Physician Fee Schedule on Nov. 1.  This final rule, which sets payment levels and other associated policies for next year, includes a number of issues important to cardiology. On a broad scale, the rule cuts payments to cardiologists by an average of 2 percent depending on the mix of services provided. It also includes the mandated 27.4 percent cut in overall Medicare payments as a result of the sustainable growth rate formula, or SGR. This cut will take effect on Jan. 1, 2012without congressional action. Other payment adjustments of note: a 29 percent reduction in payment rates for the replacement of pulse generators on pacemakers and ICDs, as well as a 25 percent reduction in payment rates for the professional component of advanced imaging services  provided by the same physician on the same day. CMS had initially proposed slashing the imaging payment rates by 50 percent, but changes its mind as a result of advocacy efforts by the ACC and others.  Learn more information about the Final Rule, including policy implications relating to e-prescribing and the physician quality reporting system.  A special webinar to discuss the coding changes included in the final rule is scheduled for Nov. 30. Registration is open at CardioSource.org/webinars. In addition, providers can also pre-order the 2012 CPT Reference Guide for Cardiovascular Coding and save 10 percent.

Don’t Ignore RUC Surveys!
Annual updates to the physician work relative values are based on recommendations from a committee involving the AMA and national medical specialty societies—the RUC. The RUC is an expert panel of the AMA and specialty societies charged with developing relative value recommendations to Medicare. A key part of the RUC process is the completion of relative value surveys. Data from these surveys are used to establish the physician work that determines Medicare reimbursement. This November, surveys will be distributed related to percutaneous coronary intervention, ablation, and extremity artery/vein ultrasound. If you are randomly selected and receive a survey, please take 15-20 minutes to thoughtfully complete it. Contact James Vavricek at the ACC at 202-375-6421 or jvavricek@acc.org if you have questions or would like to receive a survey.

Final Rule on Accountable Care Organizations (ACOs) Released
CMS recently issued its final rule on ACOs, which make it easier for doctors and hospitals to participate by cutting in half the number of performance measurements, removing the electronic health records requirement and eliminating financial risks for some groups.  Theca supported many facets of the proposed rule that was released earlier this year but expressed concerns that the requirement for ACOs to take on financial risk would make it difficult if not impossible for physicians to form together with hospitals to form an accountable care organization.  While the ACC is supportive of the focus on quality of care and the particular focus on cardiovascular care within the final rule, there must be continued flexibility for physicians and other providers to improve care.

January Deadlines Approaching
As of Jan 1, 2012, suppliers who furnish the technical component of Advanced Diagnostic Imaging (ADI) must be accredited in order to bill Medicare for these services.  For dates of service on or after Jan. 1, MACs will begin denying claims by non- accredited suppliers.  More information about Accreditation process, including a list of accrediting organizations and details of the accreditation process, is available on the CMS website and on CardioSource.org. Also, as of Jan. 2012, providers must be transitioned to Version 5010. There are certain steps that providers should be taking this fall to ensure a smooth transition. Specifically, providers should be continuing with external testing and making any system revisions. Daily transactions, such as claims and eligibility determinations, should be undergoing testing as well. More information on the transition is available on the CMS website and on CardioSource.org.

State Agency takes ACTION for Better Outcomes
The American College of Cardiology Foundation has signed an agreement with Washington State’s Clinical Outcomes Assessment Program (COAP), whose mission is to improve the quality of care for patients with heart disease who receive cardiac interventions, to use the ACTION Registry-GWTG to expand the state’s focus on care coordinate issues. This agreement is the first formal engagement for the ACTION Registry GWTG® working directly for a state agency. Washington state hospitals that perform PCIs already can use their Cath PCI Registry data to meet the COAP data submission requirements. COAP will assist NCDR in disseminating targeted marketing materials to streamline sites enrolling in the registry. Learn more about the ACTION Registry GWTG.

ACC In Touch Blog: Opening Doors for CHD Patients
The lack of continuous care for congenital heart disease (CHD) patients who are transitioning from the pediatric to adult care settings has been a concern for adult cardiology practices. Enhancing collaboration between a coordinated care team, to include congenital heart specialists, and CHD patients would open the doors to consistent and efficient treatment. In an ACC In Touch Blog post, Michael Mansour, MD, FACC, Mississippi governor and member of the Coding Task Force shares what he thinks is the essential information patients should easily be able to provide their cardiologists upon an initial visit, which includesinitial diagnosis, operations chronologically with institution and surgeon, all operative notes and most recent diagnostic studies and results. He points to the ACC’s Adult Congenital and Pediatric Cardiology (ACPC) Section and the NCDR’s IMPACT Registry™ (IMproving Pediatric and Adult Congenital Treatment) as advocates for improved treatment in CHD patients. Read the full blog and look for the Nov./Dec. issue of Cardiology magazine for an article on ACHD.

 

Significant Downward Trend in Hospitalization for Medicare Beneficiaries With HF
Overall heart failure (HF) hospitalization rates among Medicare patients has declined significantly since 1998, with the overall one-year mortality rate also declining slightly over the past decade, according to a new study published in the Journal of the American Medical Association (JAMA). Considered the largest study to date examining trends in HF hospitalization rates across the United States, it showed heart failure hospitalizations dropped nearly 30 percent between 1998 and 2008. The study authors attributed the decline to fewer individual patients being hospitalized with HF rather than a reduction in the frequency of HF hospitalizations. Other findings included: black men had the lowest rate of decline for HF hospitalization among those studied; despite the decline over the past decade the one-year mortality rate remains high – 31.7 percent in 1999 and 29.6 percent in 2008; one-year mortality rates declined significantly in four states but increased in five states. This study comes on the heels of a paper published earlier this year showing significant improvements in D2B times. To learn more about this study and to access a link to the full article, read the CardioSource journal scan.

NCDR® Debuts New Cath PCI Registry® Dashboard
The CathPCI Registry Dashboard provides users with a new look for viewing their quarterly outcomes reports and enhanced functionality that allows them to drill down, create unique comparison groups and identify gaps in care – all designed to help improve patient care. The Dashboard gives cardiologists, administrators and health care professionals another tool they can use to meet the coming demands of value-based purchasing and increased public transparency. The NCDR expects to release the Dashboard functionality for its other registries in the near future. Learn more about NCDR and the new CathPCI Dashboard.

American College of Cardiology Launches PINNACLE-AF
The American College of Cardiology (ACC) is expanding the PINNACLE Registry, with a new platform focusing on atrial fibrillation and including the next generation of anticoagulants. The new platform, PINNACLE-AF, will operate within the existing PINNACLE Registry, the largest cardiovascular outpatient database in the U.S., and part of the ACC’s National Cardiovascular Data Registry (NCDR). NCDR is the most comprehensive, outcomes-based cardiovascular patient data registry for quality improvement in the United States. PINNACLE currently has 2.1 million patient records representing valid patient encounters from hundreds of outpatient practices nationwide. Of those patients, over 100,000 have atrial fibrillation. Participation in the Registry is free to all cardiology practices. For more information about the PINNACLE Registry and PINNACLE-AF, visit www.PINNACLEregistry.org.

PINNACLE Network/Paragon Health Webinar Series to Focus on Advancing the Business of CV Care
The ACC’s PINNACLE Network is partnering with Paragon Health to present a six-part webinar series focused on "Advancing the Business of Cardiovascular Care." The webinars, all of which will take place from 4-5 p.m. (ET), are free to ACC members and will feature key health care and/or physician leaders addressing hot topics related to the evolving models of cardiovascular practice. The final two webinars on Nov. 8 and Nov. 29 will focus on optimizing revenue cycle management and aligning incentives through co-management models, respectively. Archives of the four earlier webinars are also available. Learn more at CardioSource.org/PINNACLE Network.

November ACC Update Looks at TAVR, Mended Hearts and More!
The November ACC Update video looks at a new program founded by an ACC member that helps patients live a better heart healthy lifestyle and the landmark summit on non-communicable diseases held recently in New York and attended by ACC leaders including president-elect William Zoghbi.  The update also highlights a new industry training program for medical and device representatives to learn more about cardiovascular care.  There is also an interview with ACC senior vice president Kevin Fitzpatrick who discusses the collaboration between the College and the patient-centered organization, Mended Hearts. Watch the video.

ACC Submits Comments on Proposed 2012 Medicare Physician Fee Schedule
The ACC submitted formal comments to the Centers for Medicare and Medicaid Services on its proposed 2012 Medicare Physician Fee Schedule. The letter addresses coding of certain services; expansion of the multiple procedure payment reduction policy; physician quality reporting (including future payment adjustments under the Physician Quality Reporting System); Maintenance of Certification program incentives; e-prescribing; and the Physician Compare website. Read the full letter. The final rule is expected in late October.

VIDEO: October ACC Update Looks at Reduced D2B Times, Payment Innovations and More
The latest edition of ACC Update focuses on the stunning improvements in door-to-balloon (D2B) times for patients undergoing percutaneous coronary intervention following an acute myocardial infarction. In addition, ACC CEO Jack Lewin, MD, and health care economist Len Nichols, PhD, discuss payment innovations in health care, including the ACC’s new Community on Payment Innovation led by Nichols. The video also looks at the future of lifelong learning and membership opportunities. Watch the complete video.

New Online Community Focuses on Payment Innovations
The American College of Cardiology (ACC) and the American Journal of Managed Care (AJMC) have launched a new online “Community on Payment Innovations,” funded by Johnson & Johnson, with the goal of bringing together a unique combination of key stakeholders to advance the payment reform debate, encourage innovation and collaboration, and share best practices and lessons learned. This group, led by health care economist Len Nichols, PhD, will discuss new and innovative payment models to improve the health care system by bending the cost curve, with the Patient Protection and Affordable Care Act as the backdrop. The cardiovascular community, physicians, providers, practice administrators, health policy professionals, health care economists, federal and state governments, early innovators, payers and other health care stakeholders are encouraged to participate in the discussions.

Cardiologists on the EMR incentive uptake
Fifty-five percent of cardiologists who responded to an American College of Cardiology (ACC) survey are either participating or plan to participate in the Centers for Medicare and Medicaid Services’ (CMS) Electronich Heatlh Record (EHR) Incentive Program. Thirty-four percent have already registered, according to the survey published in the College’s Cardiology magazine. CMS reported that in July, cardiology was the third highest specialty to participate in EHRs. The ACC's July survey of a 152 randomly selected panel of members found that 34 percent of participants reported that they have registered for the EHR Incentive Program, and about half of that group—18 percent of total respondents—have met the requirements for the program and have attested to doing so. Read more about this topic in Cardiovascular Business and in Cardiology magazine.

HHS Approves Plan to Screen All Newborns for Congenital Heart Defects
U.S. Department of Health and Human Services Secretary (HHS) Secretary Kathleen Sebelius approved the Secretary's Advisory Committee for Heritable Disorders in Newborns and Children recommendation to add a screening for critical congenital heart defects to the recommended universal screening panel. This means that all children born in the U.S. will be screened for congenital heart defects within the first 48 hours of life using pulse oximetry. The American College of Cardiology, along with other members of the congenital heart disease community, played an important role in making this a reality.

ACC IN TOUCH BLOG: Next Steps for Reducing PAD Prevalence
The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) released updated guidelines for the diagnosis and management of peripheral artery disease (PAD). The updated document provides agreed-upon approaches and treatments for PAD that clinicians can apply to help improve patient care. The guidelines include expanded criteria for using the ankle-brachial index (ABI) for earlier diagnosis; increased efforts to ensure all patients have access to smoking cessation services, improved use of clot-preventing medications, as well as a more focused definition of effective interventions for avoiding limb amputations and treating aortic aneurysms. In an ACC In Touch blog post, Thom Rooke, MD, FACC, and Alan T. Hirsch, MD, FACC, chair and vice chair of the PAD Guidelines Writing Committee, respectively, called the guidelines a road map to greater prevention opportunities, which will be necessary if we are to reduce the number of people needlessly affected by PAD. Read more on the ACC In Touch blog.

PINNACLE Network/Paragon Health Webinar Series to Focus on Advancing the Business of CV Care
The ACC’s PINNACLE Network is partnering with Paragon Health to present a six-part webinar series focused on "Advancing the Business of Cardiovascular Care." The webinars, all of which will take place from 4-5 p.m. (ET), are free to ACC members and feature key health care and/or physician leaders addressing hot topics related to the evolving models of cardiovascular practice. Registration is open for the three remaining webinars. In addition, archives of the previous webinars are also available. Register today at CardioSource.org/Webinars!

• Cardiovascular Service Line: Building a Foundation for Success - Understand the key elements for achieving alignment across the hospital and practice to bridge siloes and transform from a product line to a CV enterprise. (Oct. 18)
• Private Practice Success Strategies: How to Optimize Revenue Cycle Management - Focus on the best practices necessary for developing a meaningful revenue cycle management function within physician practices and learn what common pitfalls to avoid. (Nov. 8)
• Aligning Incentives Through Co-Management Models - Understand the key elements of clinical co-management structures through case study presentations and expert commentary. (Nov. 29)

Early Bird Registration is Now Open for ACC.12
The American College of Cardiology’s 61st Annual Scientific Session & Expo reflects the College’s passion for science, education and peer-to-peer networking. ACC.12 in Chicago will highlight the ACC’s focus on lifelong learning and practice improvement, and will feature a new learning pathway structure to better address the needs of cardiovascular professionals round the globe. New this year: ACC.12 will officially kick off with the opening session at 8 a.m. on Saturday, March 24, and will close on Tuesday, March 27, at noon with a brand new ACC.12 Innovators session featuring the top leaders in cardiology. Register by November 8 for special early bird registration rates and the best availability of hotels. For more information visit www.accscientificsession.org.

New Spanish Language Patient Education Video on Cardiac Rehab
In collaboration with CardioSmart, the Coalition to Reduce Disparities in Cardiovascular Outcomes (credo) has released a Spanish-language patient education video extolling the benefits of cardiac rehabilitation. Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, the National Alliance for Hispanic Health, the National Hispanic Cardiology Leadership Network and the Preventive Cardiovascular Nursing Association, the video highlights barriers to enrollment and completion of cardiac rehab and how patients overcome such barriers through vignettes of three cardiac rehabilitation program enrollees. Email credo@acc.org to request a free DVD copy.

New Study Using NCDR Data Looks at Appropriate Use of PCI
A new study based on NCDR® data titled “Appropriateness of Percutaneous Coronary Intervention (PCI),” shows that although the majority of patients are appropriately selected for PCI procedures, there are opportunities for improvement, especially in the non-emergency setting. Published in the Journal of the American Medical Association, researchers useddata from the CathPCI Registry® the vast majority of PCIs performed in acute settings (98.6 percent) were classified as appropriate. For non-acute indications, however, 11.6 percent were classified as inappropriate, with substantial variation noted across hospitals. Studies like these are extremely beneficial to patients and to the entire field of medicine. They highlight the important role registries can play in identifying opportunities for individual hospitals and practices to monitor their performance and adopt or develop quality improvement initiatives to optimize the care they deliver. For more information on the study, click here. You can also learn more about the College's ongoing efforts related to appropriate use of PCI and other therapies and procedures in the "Appropriate Use" issue center on CardioSource.org.

ACC Testifies at FDA Advisory Committee Hearing on SAPIEN Transcatheter Heart Valve
American College of Cardiology (ACC) President David Holmes, Jr, MD, FACC, represented the College at an FDA Advisory Committee meeting in July regarding pre-market approval of Edwards Lifesciences SAPIEN Transcatheter Heart Valve. Leaders from the Society for Thoracic Surgery (STS) and the Society for Cardiovascular Angiography and Interventions (SCAI) also spoke. The ACC is working closely with STS, SCAI and others to align efforts to ensure the physician community is prepared to appropriately use this new technology and techniques. The panel voted on three main questions following the hearing, in general agreeing to recommend approval of the device. The panel – for the first time ever – also recommended that Edwards be required to have all users of the device participate in a professional society registry like NCDR®. The next step is FDA approval. The ACC has posted a detailed summary in the FDA Issues center on CardioSource.org that includes links to the official statements, more information on the specific committee questions, and background information on the PARTNER trial and ACC/STS efforts related to TVT. A video with Holmes and STS President Michael Mack, MD, FACC, is also available.

FDA Approves Ticagrelor
The Food and Drug Administration has approved the anti-platelet drug ticagrelor for patients with acute coronary syndromes (ACS). A boxed warning to health care professionals and patients warns that aspirin doses above 100 milligrams per day decrease the effectiveness of the medication. It also notes that, like other anti-platelet agents, ticagrelor increases the rate of bleeding and can cause significant, sometimes fatal, bleeding. The ACC will be working with the American Heart Association and Heart Rhythm Society to incorporate ticagrelor into future guidelines. Learn more about the decision.

Call for Innovative Payment Models!
The ACC, in partnership with the American Journal of Managed Care (AJMC) and with sponsorship from Johnson & Johnson, is creating a first-of-its-kind "Community on Payment Innovations" with the goal of providing an interactive, online venue where cardiovascular professionals and others can engage in meaningful dialogue to advance current and innovative payment models. The community will feature, among other things, case studies, videos, webinars and hot topic discussions. While an editorial panel of experts is already in place and developing venerable content and identifying discussion topics, the College is also seeking expert advice from members currently involved with testing and/or implementing new payment models. The goal is to use these "case studies" as the basis for discussion when the community launches in September. Submissions should be sent to advocate@acc.org with "Payment Models" in the subject line.

Registration Deadline Extended: Don’t Miss the 2011 Legislative Conference!
The registration deadline for this year’s Legislative Conference taking place Sept. 11-13 in Washington, DC, has been extended to August 14. The agenda is shaping up to include key congressional members, their staff and health policy leaders speaking to hot topics like health reform implementation, payment innovation and regulatory trends. General Stanley McChrystal also will address participants on the subject of leadership during the Sunday night's dinner to benefit the ACC Political Action Committee (PAC). Tickets are required for the dinner. General admission is $250 per person ($50 for FITs, CCAs and Practice Administrators). VIP admission, which includes preferred seating and a meet-and-greet reception with the general prior to the dinner, is $1,000 per person ($250 for FITs, CCAs and Practice Administrators). As always, participants will head to Capitol Hill on Tuesday to meet directly with their congressional delegation. More information is available at CardioSource.org/LegislativeConference.

Read the July/August Issue of Cardiology
The latest issue of Cardiology magazine has arrived! Don’t miss great articles on medication adherence, sleep apnea and the latest NCDR research. In addition, the magazine includes a feature on the Puerto Rico Chapter’s efforts to engage FITs and patients, as well as an overview of the state-level advocacy issues facing chapters across the country. Read the latest issue at CardioSource.org/CardiologyMagazine. Also look for extended coverage on credo and breaking news items throughout the month of August. In addition, the Cardiology online site includes a special discussion forum and options to download the new Cardiology app for your iPad or iPhone.

PINNACLE Network/Paragon Health Webinar Series to Focus on Advancing the Business of CV Care
The ACC’s PINNACLE Network is partnering with Paragon Health to present a six-part webinar series focused on "Advancing the Business of Cardiovascular Care." The webinars, all of which will take place from 4-5 p.m. (ET), are free to ACC members and will feature key health care and/or physician leaders addressing hot topics related to the evolving models of cardiovascular practice. Whether you are staying in private practice, or are fully or partially integrated with a hospital system, this series is for you. Register today at CardioSource.org/Webinars!

• Physician-Hospital Alignment: The Fundamentals of Integration - Learn about current integration models and trends and hear from experts on the elements necessary for a successful integration. (Sept. 7)
• Integration is not Alignment: Constructing Sustainable Models - Hear from experts on the common obstacles to sustaining integration and alignment and gain insight into best practices. (Sept. 22)
• Effective Governance: Best Practices in Decision Making - Learn more about the basic tenets of sound practice in both private and integrated settings and hear from leaders on the challenges and best practices associated with transitioning from private to integrated models. (Oct. 4)
• Cardiovascular Service Line: Building a Foundation for Success - Understand the key elements for achieving alignment across the hospital and practice to bridge silos and transform from a product line to a CV enterprise. (Oct. 18)
• Private Practice Success Strategies: How to Optimize Revenue Cycle Management - Focus on the best practices necessary for developing a meaningful revenue cycle management function within physician practices and learn what common pitfalls to avoid. (Nov. 8)
• Aligning Incentives Through Co-Management Models - Understand the key elements of clinical co-management structures through case study presentations and expert commentary. (Nov. 29)

Prepare for Jan. 1 HIPAA compliance with new AMA toolkit
If physician practices or vendors submit claims electronically, they must adhere to the Jan. 1, 2012 compliance deadline for using Version 5010 of the HIPAA electronic standard transactions. Noncompliance puts physician practices at risk for rejected claims and cash flow interruptions. Learn the steps needed to comply with the new 5010 toolkit from the American Medical Association (AMA). The toolkit explains the differences in Version 5010, how to test readiness for the Version 5010 transactions, and steps to take to prevent interruptions to cash flow. Access the toolkit and additional resources. Also visit the “Coding and Billing” section of CardioSource.org/Practice-Management for ACC resources on this issue.

Introducing the newest Meeting on Demand ™ Program: Recent Advances in Clinical Nuclear Cardiology and Cardiac CT
Physicians can now explore the “Recent Advances in Clinical Nuclear Cardiology and Cardiac CT” live program anytime with the ACC’s most recent Meeting on Demand™ Program. The program will survey the various imaging modalities and cutting edge technologies and offer healthcare professionals the opportunity to listen to lectures from the experts with slides synched to audio covering developments in the field.

ICACTL Hosts Webinar Accreditation Series
The Intersocietal Commission for the Accreditation of Computed Tomography Laboratories (ICACTL) is hosting two free webinars on August 16 on accreditation and the ICACTL process. The webinars will focus on the key elements of submitting a successful application for accreditation. Mary Lally, MS, RT(R) (MR), IAC Director of Accreditation-MR/CT/Carotid Stenting will discuss the website, online application and the most common reasons for delayed accreditation. A live question and answer session at the end of the presentation will be available. The American College of Cardiology (ACC) is a sponsoring organization.
Register for the August 16 webinar at 10:30 a.m. ET
Register for the August 16 webinar at 5 p.m. ET

Find best practices for appropriate use of imaging in the FOCUS Innovation Community
The FOCUS Innovation Community provides an online forum for members to exchange ideas and experiences on the appropriate use of cardiac imaging. This online environment complements the FOCUS performance improvement module and offers educational and networking opportunities for those interested in appropriate use criteria. Join the FOCUS Innovation Community.