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Medical Liability
Starting in 2011, HHS will award five-year demonstration grants to states to develop, implement and evaluate alternative medical liability reform initiatives, such as health courts and early-offer programs. In addition, medical liability protections under the Federal Tort Claims Act will be extended to free clinics. The ACC will work with ACC chapters as this provision is implemented. The ACC continues to advocate for federal enactment of proven, meaningful liability reforms. Physician-owned hospitals that do not have a provider agreement prior to Dec. 31 are prohibited. Physician-owned hospitals with a provider agreement prior to Dec. 31 are allowed to continue Medicare participation subject to certain reporting requirements. The ACC opposes the ban on new physician-owned facilities and restrictions placed on current facilities. The ACC supports physician ownership in facilities, equipment or services that benefit patients through the delivery of appropriate, high quality medical care. The ACC believes all facilities should strive to enhance quality of care, efficiency and patient access, while ensuring that ownership interests are directed to improving the delivery of care through implementation of quality systems and measures.
Independent Payment Advisory Board (IPAB)
The IPAB is a 15-member board tasked with developing and presenting proposals to the president and Congress, starting in 2014, to extend the solvency of Medicare, slow cost growth, improve quality of care and reduce national health expenditures. In years when Medicare costs are projected to be unsustainable, IPAB’s proposals automatically will be implemented unless Congress approves alternatives that achieve the same level of savings. IPAB’s members will be appointed by the president and approved by the Senate for six-year terms. Members could include individuals with national recognition for expertise in health finance and economics, actuarial science, health facility management, and other related fields, including physicians/other health professionals, experts in pharmaco-economics or prescription drug benefit programs, employers, third-party payers, individuals skilled in health-related research and interpretation, as well as representatives of consumers and the elderly. Hospitals are exempt from payment modification proposals from IPAB until 2020. The ACC is concerned by the authority granted to an independent body of unelected officials to determine payment cuts for physicians. Physicians already are subject to an expenditure target and other potential payment reductions as the result of the Medicare physician payment formula. The College believes it does not make sense to subject physicians to expenditure targets while at the same time exempting large segments of Medicare providers who are subject to no target at all. The ACC believes that because the IPAB has broad discretionary authority to make radical changes in the structure of the Medicare program, its recommendations should require an affirmative vote by Congress before they can be implemented. Congress should retain the ability to achieve a different level of savings than proposed by the IPAB to adjust for new developments that warrant spending increases, and maintain its ultimate accountability for the sustain- Claims Submission ability and stability of the Medicare program.
By 2013, manufacturers of pharmaceuticals, devices, biologicals and supplies will be required to disclose information regarding payments made to health care professionals. The types of payments implicated include consulting fees, honoraria, research funds, grants, support for continuing medical education, gifts, entertainment and others. The information will be made available to the general public later that same year. The ACC supports disclosure of potential conflicts of interest. Opinions expressed in Cardiology are those of the identified authors and do not necessarily reflect the opinions or policies of the American College of Cardiology. Also, paid advertisements do not reflect an endorsement of a product or program by the ACC. All advertisements are subject to review and approval by the ACC. The ACC reserves the right to decline, withdraw or modify advertisements at its discretion. Given the partisan environment and the lack of a public majority of support for national health reform, it’s almost a miracle that the Patient Protection and Affordable Care Act (PPACA) passed in March.