Alliance Responds to Discussion Draft

The Alliance of Specialty Medicine, which includes the Heart Rhythm Society as a member, sent a letter commenting on the U.S. House of Representatives health care legislation discussion draft, which was released on June 26, 2009. The letter was sent to Rep. Charles Rangel (D-NY) and Rep. Dave Camp (R-MI), respectively, Chairman and Ranking Member of the Committee on Ways and Means); Rep. George Miller (D-CA) and Rep Howard McKeon (R-CA) respectively Chairman and Ranking Member of the Committee on Education and Labor; and Henry Waxman (D-CA), and Rep Joe Barton (R-TX), respectively Chairman and Ranking Member of the Committee on Energy and Commerce. View the full letter (PDF, 138K).

Physician Payment Update
"The Alliance strongly supports the proposal to establish a new baseline for physician payments, and to remove the cost of prescription administered in the physician’s office from the formula. The Alliance appreciates the effort to move toward preventive care but emphasizes that health care reform should protect access to specialty care as well."

Physician Quality Reporting Initiative (PQRI)
"The Alliance thanks the Committee on the proposal that would refine the PQRI program, particularly allowing physician access to their data in timely manner, providing physicians with a reasonable appeal process and ensuring that PQRI is not punitive."

Health Information Technology (HIT)
"The Alliance is pleased that your proposal ensure a better integration of PQRI with the HIT meaningful-use definition. However, the Alliance expresses concerns regarding the timeline related to the HIT adoption and urges the committees to amend the current timelines."

Comparative Effectiveness Research (CER)
"The Alliance emphases that CER should enhance information about treatment options and outcomes for patients and physicians to help them choose the best care that meet patient’s need."

Financial Relationships with Industry
"The Alliance is pleased with the proposal about the financial relationship between physician and industry. The Alliance believes that while relationships between physicians and industry are an important component of advancing medical technologies and improving patient care, uniform procedures for transparent disclosure must be in place to minimize confusion and misrepresentation. The Alliance also encourages the Committees to adopt language that would provide physicians with the ability to correct inaccuracies in their report and provide background information on their relationships with industry prior to the public release of this information.

"However, the Alliance is extremely concerned about the proposed restrictions on funding of continuing medical education courses. There is a legitimate place for ethical partnerships between industry and medical associations and this support has long helped support the advancement of cutting edge science, clinical innovation and continuing medical education."

Public Health Option
"The Alliance of Specialty Medicine does not have a specific position regarding the establishment of a public plan option; however, we oppose requiring mandatory participation by Medicare providers to also participate in any public health insurance plan. We are further concerned that directly linking the payment mechanisms between Medicare and the public health insurance plan is under consideration, even if the rates are slightly increased above Medicare rates."

Overvalued Services
"The Alliance is very concerned about your proposal to address suspected over-valued physician services by having the Center for Medicare and Medicaid Services (CMS) directly evaluate and adjust payment for potentially misvalued physician services. We believe that there is already a process in place (i.e the AMA RUC process), which assures physician input from a variety of disciplines to examine potentially misvalued physician services."

Quality Measurement
"The Alliance welcomes this proposal to further strengthen and improve quality measurement and development processes. We recommend that these resources be used to fill gaps in clinical research that will allow us to build a better supply of evidence-based clinical practice guidelines, to fund clinical data registries and other innovative quality improvement activities, to develop valid risk adjustment mechanisms that will allow us to take full advantage of clinical outcomes data, and to conduct studies on whether currently used measures have any impact on quality and cost."