Waiting for the spark from heaven to fall

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Awaiting potentially negative news can instill the type of anticipatory drama suggested by Victorian British poet Matthew Arnold. Currently, many cardiologists may be just that anxious to hear CMS’ final determination on their physician fee schedule for 2010, which is scheduled to be issued by Nov. 1.

Starting Jan. 1, 2010, the rule could deal a significant blow to specialists. Specifically, the changes in utilization assumption combined with practice reimbursement expenses could cut payments to cardiologists by 11 percent and for nuclear medicine procedures by 13 percent.

However, the American College of Cardiology (ACC) said that the projected payment cut would result from changes to the following areas: practice expense calculation; equipment utilization rates; malpractice rate calculation; and payment for consultations.

Meanwhile, the Senate is still in a contentious battle over the repealing of the sustainable growth rate formula, after failing last week to get enough votes to force an up-or-down vote on S. 1776 (Medicare Physician Fairness Act). Yet, certain senators, such as Harry Reid, D-Nev., and Patrick Leahy, D-Vt., said that they are “determined to continue working” on revoking the “flawed formula.”

Without the passage of the Senate bill, the ACC has determined there will be a 21.5 percent reduction in the Medicare conversion factor due to the flawed sustainable growth rate.

As a result, there could be as high as a combined 30 percent cut in Medicare payments for cardiology.

In response, ACC has developed a practice expense calculator that you can use to gauge the impacts on your practice.

Of course, these immediate changes are occurring amid the backdrop of the ongoing healthcare reform debate. After the Senate Finance Committee completed its historic vote to pass along its legislation two weeks ago, there has been nothing but discussions and markups on the Senate floor. To add to the fray, this week, Reid reaffirmed his intention to attach a public option plan to the Senate Finance Committee bill—with an opt-out clause for states that do not wish to participate.

In these arduous processes to better the practice of cardiology and the U.S. healthcare system, in general, Arnold’s words may again provide solace: The pursuit of perfection, then, is the pursuit of sweetness and light.

On these topics, or any others, please feel free to contact me.

Justine Cadet