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.

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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 blog.

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Be an 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.

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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.

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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.

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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.

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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.

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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.

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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).

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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.

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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.

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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.

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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:

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

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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.

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