Judge dismisses cardiology suit regarding Medicare physician payment cuts

A district court recently judge handed the American College of Cardiology a legal setback after the group had filed a suit against the Department of Health and Human Services alleging that cuts in the 2010 Medicare Physician Fee Schedule were ill-conceived and would harm patients’ access to care.

The American College of Cardiology (ACC) filed the suit against Health and Human Services Secretary Kathleen Sebelius and the Centers for Medicare & Medicaid Services (CMS) in December of 2009. The suit was dismissed last week.

According to a statement published by the ACC, a judge for the Southern District of Florida dismissed the suit on jurisdictional grounds stating, “The statutory language governing the Medicare program precludes judicial review of the relative value units and the methods for determining the relative value units in the Medicare fee schedule.”

According to complaint filed by the ACC, the CMS ruling on the 2010 Medicare Physician Fee Schedule “indiscriminately and irrationally slashes Medicare payments for all services performed and billed by cardiologists based on information that fails to meet applicable standards for the appropriate use of such data and where the Secretary’s own consultant has acknowledged is erroneous and flawed.”

Data from the Physician Practice Information Survey, used to justify the cuts in the payment schedule, was collected from 145 cardiologists. Of those, 55 responses were used to compile the practice expense data for cardiology services, which was less than the survey’s stated goal to use at least 100 respondents per medical specialty, the ACC alleged.

After the judge’s ruling, the ACC released a statement in the ACC Advocate.

“While we are obviously frustrated by the court’s decision, there is no denying that this was going to be an uphill battle given the traditional hesitancy of any court to take on the federal government,” the group wrote in the statement.

Reference:
www.acc.org