Urge Your Member of Congress to Cosponsor H.R. 3107

Colleagues-

PLEASE ACT NOW TO REFORM PRIOR AUTHORIZATIONS!

Congress has heard our demands for reforming the prior authorization process and will be voting on HR 3107 (details of bill below).

PLEASE Use the link below to write, email, and call your congressperson.

Using the link below, we emailed our representatives in less five minutes and included a personalized story. You can too!

Thanks,

Jason Reingold, MD, FACC
Pascha Schafer, MD, FACC
GA Advocacy and Regular Committee Chairs


Significant, bipartisan federal legislation was recently introduced that would provide necessary reforms to the prior authorization process. We urge you to ask your member of Congress to support the Improving Seniors’ Timely Access to Care Act of 2019 (H.R. 3107). The legislation would make several changes to items and services in Medicare Advantage plans. Specifically, the bill would: 

  • Create a “real-time” electronic prior authorization process, developed by the Secretary of HHS, for items and services that are routinely approved;
  • Improve transparency by requiring plans to report to CMS on the extent of their use of prior authorization and the rate of approvals or denials;
  • Require plans to adopt transparent prior authorization programs that are reviewed annually, adhere to evidence-based medical guidelines, and include continuity of care for individuals transitioning between coverage to minimize any disruption in care; 
  • Hold plans accountable for making timely prior authorization determinations and to provide rationales for denials;
  • Prohibit additional prior authorization for medically-necessary services performed during a surgical or invasive procedure that already received, or did not initially require prior authorization. 

The ACC has been a driving force behind the introduction of this legislation, working with the authors to ensure that this will make a series of positive reforms to improve patient care. It is our hope that this important step forward will bring about much needed changes to the prior authorization process.

Urge Your Member of Congress to Cosponsor H.R. 3107

Join ACC’s Member Hub Today

Sign Up for ACC’s MEMBER HUB Today

ACC has launched a new initiative designed to be the focus of communication within the specialty. It’s called Member Hut. We urge you to sign up today so you will not miss important developments on the national level as well as in our state.

What are the benefits of ACC’s Member Hub?

  • It’s going to be our one-stop shopping for all things ACC.
  • Members will have a place to connect with their colleagues, whether it be through mentoring, getting advice on the discussion boards, or posting pictures from that awesome poster session. And that’s just a few of the possibilities!
  • There will be private groups; for Chapters, for Sections, for Task Forces, for Committees, and other member groups.
  • Great place for our Council and committees to gather virtually, store and share documents, trade ideas.

We encourage you to join today; you can do that by going to MemberHub.acc.org and using your acc.org username and password to sign in. In the next few weeks, we’ll be adding sub groups for our Council and committees.

 

 

New Shared Decision Making requirements for ICD reimbursement

Watch ACC/HRS Leaders Discuss New CMS ICD Policy and Shared Decision-Making Requirement. The Centers for Medicare and Medicaid Services (CMS) recently released a final policy decision updating the national coverage determination (NCD) governing implantable cardioverter-defibrillator (ICD) implantation for Medicare fee-for-service patients.

The policy includes a requirement for a shared decision making encounter for four of the six covered indications for ICD implantation. Learn more about the policy and new requirement, including a case study of a shared decision-making tool used at the VA Eastern Colorado Health Care System, in a joint ACC and Heart Rhythm Society (HRS) webinar.

View the webinar here: ow.ly/eyH030iOotS

TAVR Decision Aid Tools Now Available

The ACC’s CardioSmart Decision Aids hub recently expanded to include two new TAVR Decision Aid Tools that help patients understand what aortic stenosis (AS) is and what treatments are available. The first tool guides patients with intermediate or high surgical risk through the treatment options available for severe AS and helps them choose between TAVR and surgery. The second tool is dedicated to patients with prohibitive surgical risk/inoperable to help them evaluate the proper treatment and choose between TAVR and symptoms management. Visit CardioSmart.org/Decisions to find out more and download these tools for free.

Help Solve Prior Authorization Challenges

November is here and that means it’s time to submit your prior authorization data via ACC’s web-based prior authorization tool (PARTool). Do your PART to improve the prior authorization process by recording incorrectly denied or difficult requests through ACC’s PARTool for the entire month. The data collected helps the College determine overall prior authorization and test substitution trends and better understand problematic areas of the process including time burdens, test substitution and peer-to-peer reviews. The observed trends will be shared with insurers, vendors, state legislators and insurance officials to engage them in ACC’s efforts to reduce the burden of prior authorization and return attention to direct patient interaction. Practices can submit through a simple online form at ACC.org/PARTool.

To be successful on a larger scale to solve prior authorization challenges – we must all work together to find a solution that ultimately saves time, saves money, and—most importantly—saves lives. So please help and do your PART!