In an effort to get an injunction to stop the January 1st 40% reduction in Medicare reimbursements to heart specialists for vital routine office procedures, the American College of Cardiologists (ACC) has filed a lawsuit against the administration, specifically, the Secretary of Health and Human Services, Kathleen Sebelius. The cuts involve imaging and diagnostic tests, changes that will increase the mortality rate according to Jack Lewin, CEO of ACC. The organization represents  90% of the 40,000 heart specialists in the United States.

This reduction in fees has nothing to do with the health care reform legislation proposed in the House and the Senate. According to the government's Centers for Medicare & Medicaid Services (CMS), cuts are mandated by law not to increase the cost of reimbursement spending each year. This is not the first time cuts have occurred. The profession has seen regular cuts over the last five years while costs have continued to rise.

Lewin also emphasized that lower income people and those in rural areas will suffer most as costs increase and access decreases. The four major cardiology groups in urban Kansas City are already selling their community based practices and moving out of the city to urban hospitals. Similar moves are taking place in areas throughout the country as heart specialists cut staffs, sell equipment, close offices and/or move to hospital environments. Once cardiologists make these changes from private practices to hospital environments, reversal won't happen, says Lewin.

Dr. Lewin also remarked that the ACC, one of the few health organizations attempting to work with government to promote health care reform, was stunned that nothing was being done to alter the rule. The government's own consultant group had advised Medicare that the survey data they used to justify the cuts was flawed.

During the last ten years, the management of people with cardiac diseases in the United States has resulted in a 30% reduction in the mortality rate, thanks to dedicated specialists and heavy investing in expensive equipment. This 30% could be reversed if cuts in the reimbursement fees cannot be stopped.

The affected imaging and diagnostic tests will still be available in hospitals but the costs are three times more than they are in community based private practices. So the costs to Medicare go up substantially while access to vital services is already going down.

Peter Ashkenaz, spokesperson for the Centers for Medicare and Medicaid Management, said "CMS can't comment on the suit, but strongly believes that the 2010 physician payment rule ensures that Medicare beneficiaries continue to have access to the services provided by all physicians and that those physicians are paid appropriately. The rule was adopted after the opportunity was provided for public comment, including affected medical specialties."

Jack Lewin of the ACC said the cardiologists did respond in opposition. In addition to requesting an injunction, the American College of Cardiology is asking that the government conduct a new survey to get valid data.

Annie believes the writing is on the wall when it comes to Medicare cuts as advocated by proposed health care reform legislation and this is proof.

Copyright 2009 Grass Roots Annie