ACC sues HHS over Medicare cuts

Dec 28, 2009

The American College of Cardiology (ACC) filed suit on Monday against the U.S. Department of Health and Human Services (HHS), alleging that severe cuts in the 2010 Medicare Physician Fee Schedule will render the practice of cardiology "nonviable and unsustainable."

The suit was filed against Secretary Kathleen Sebelius in U.S. District Court for the Southern District of Florida, along with motions for a preliminary injunction and expedited discovery, according to the Washington, DC-based ACC.

The ACC said it had "exhausted all its regulatory and legislative options" to halt cuts in the 2010 Medicare Physician Fee Schedule, leaving it with no alternative to a lawsuit. Payment cuts as high as 40% are so severe that they "threaten access to patient care" and increase Medicare costs by forcing the wholesale selling of cardiology practices in the U.S. to hospitals, the statement said.

"You can't unring the bell" on what's happening to cardiology as a result of the payment cuts, said ACC CEO Jack Lewin in a video on the ACC's Web site.

"Probably 20% of our membership has already sold their practices to hospitals ... and many others are in the process of selling," he said, adding that income for cardiologists' bread-and-butter procedures such as echocardiography and nuclear stress testing "are so underfunded that they are nonviable." The transfer of cardiology practice to hospitals will ultimately raise the cost of care, threatening patient access, the video statement concluded.

The complaint alleges that Sebelius unlawfully adopted the payment rates for cardiology services in the 2010 Medicare Physician Fee Schedule based on faulty data.

"Clear and critical defects exist within the Physician Practice Information Survey (PPIS), which was used to justify cuts to Medicare reimbursements rates for cardiology and which directly undermine the viability of community practices," the statement said.

The ACC said it hopes the court will schedule a hearing on its motion for a preliminary injunction prior to January 15, 2010, "before any 2010 Medicare payments are actually issued. The organization "will continue to pursue its legislative and regulatory efforts concurrent to the legal action to find a reasonable solution that minimizes the impact to other specialty societies, while addressing the unjustified and unreasonable cuts to cardiology," the ACC stated.

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