Cardiologists sue Sebelius over Medicare fee cuts

by Steve Sternberg
USA Today
12/23/2009

Heart specialists on Monday filed suit against Secretary of Health and Human Services Kathleen Sebelius in an effort to stave off steep Medicare fee cuts for routine office-based procedures such as nuclear stress tests and echocardiograms.

The lawsuit, filed in U.S. District Court for the Southern District of Florida, charges that the government’s planned cutbacks will deal a major blow to medical care in the USA, forcing thousands of cardiologists to shutter their offices, sell diagnostic equipment and work for hospitals, which charge more for the same procedures.

“What they’ve done is basically killed the private practice of cardiology,” says Jack Lewin, CEO of the American College of Cardiology (ACC), which represents 90% of the roughly 40,000 heart specialists in the USA.

The issues raised in the lawsuit are not related to the health reform legislation being hammered out on Capitol Hill. But the dispute offers a revealing case study of the impact of payment reform on one specialty — cardiologists — and, ultimately, their patients.

It also illustrates the vulnerability of the heart doctors, who over the past few decades have invested heavily in nuclear scanners and other costly tools of their trade only to discover that they may be too expensive to operate in an era of increasing restraint on medical costs.

Victor Fuchs, a professor of health economics at Stanford University, says the outcry among cardiologists should come as no surprise in a system that has long rewarded doctors for investing in technology.

“What you really need is a reimbursement system that brings about a more rational use of these devices and a more rational investment in them,” he says. “That’s never going to happen without a lot more pain and suffering on the part of the people who are affected by the shift.”

Medicare’s new fee schedule would cut reimbursements for nuclear scans by about 40% as of Jan. 1, according to the ACC…

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