OCTOBER 2020 VIEW ONLINE
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ABC Call to Action — Ask Congress to Stop Medicare Physician Payment Cuts

On August 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued its 2021 Medicare Physician Fee Schedule (PFS) proposed rule. As a consequence of broad changes finalized in 2019 related to evaluation and management (E/M) services, nearly all physician specialists will see payment cuts next year. Cardiologists are projected to experience a one percent increase in their Medicare Part B payments on average. But for cardiologists who rely on imaging to diagnose and manage their patients or those who specialize in surgical procedures to treat cardiovascular disease, the effect of the proposed conversion factor cut will be devastating.

These anticipated cuts will be layered on top of unreimbursed costs physician practices must absorb to safely provide care throughout the pandemic and Medicare payments that have not kept pace with inflation.

With the demand for relief from the financial fallout of the pandemic coming from every sector of our nation’s economy, physicians must make their voices heard to ensure they are not overlooked by Congress as future COVID-relief legislation is considered.

This election year, lawmakers are particularly attuned to their constituents. Take a moment to send an email to your members of Congress and ask them to act to stop Medicare cuts to physicians from taking effect. Don’t stop there. Look for opportunities during this election season and beyond to engage with lawmakers, including virtual town halls and campaign events. Lawmakers need to hear from their physician constituents if they are to be compelled to act on your behalf.

Learn how to take action here.

 ADVOCACY NEWS
ABC Comments on Medicare Physician Fee Schedule Rule
On October 5, ABC submitted comments to the Centers for Medicare and Medicaid Services (CMS) on proposed Medicare physician payment policies for calendar year 2021. In the letter, ABC urged the Agency to take immediate actions to delay or mitigate the proposed cut to the 2021 conversion factor that will result in Medicare physician payment reductions next year.

The dramatic reduction to the conversion factor arises from budget neutrality requirements that are being triggered as a result of previously finalized evaluation and management (E/M) code policies that will take effect on January 1, 2021.

In the letter, ABC highlighted the toll of COVID-19 on cardiology practices and the threat Medicare physician payment cuts pose to the viability of physician specialists, especially those practicing in medically underserved and rural areas.

The letter also expressed support for proposed telehealth policies and asked that telehealth flexibilities put in place during the public health emergency be continued through the end of the year following the year in which the public health emergency ends, including continuing paymets for telehealth and audio-only services, at the same rate as in-person services.

ABC also echoed in its letter concerns raised by the American Medical Association about proposed changes to the CPT code descriptors and instructions for remote patient monitoring. ABC voiced that proposed clarifications around what constitutes “interactive communication” will discriminate against those in rural areas and minority populations for whom there is a digital divide.
Lawmakers Aim to Stop Preventable Non-traumatic Amputations
Reps. Donald Payne, Jr. (D-NJ), Ruben Gallego (D-AZ), Bobby Rush (D-IL), Bennie Thompson (D-MS), Eddie Bernice Johnson (D-TX) and Lisa Blunt Rochester (D-DE) have introduced the Amputation Reduction and Compassion (ARC) Act which seeks to reduce the number of avoidable amputations suffered by peripheral artery disease (PAD) patients.

The legislation will reduce amputations by requiring Medicare, Medicaid, and group health insurance plans to cover preventive screenings for high-risk individuals so perhipheral artery disease (PAD) can be caught and treated early, before it leads to amputation. The bill would also disallow payments for non-traumatic amputations if anatomical testing is not performed first. It also establishes a PAD education program at the Department of Health and Human Services (HHS) so physicians are more aware of PAD symptoms and requires HHS to implement quality payment measures that will reduce avoidable amputations.

The issue of unnecessary amputations caught the attention of lawmakers following the publication of a ProPublica story that featured the efforts of Foluso Fakorede, MD to lower the rates of non-dramatic amputations among those living in the Mississippi Delta.

Last November, the ABC called upon the House Ways and Means Committee’s Rural and Underserved Communities Health Task Force to take steps to improve the health of minorities in rural and underserved areas, including requiring arterial testing before non-traumatic amputation.

Ask your member of Congress to cosponsor the ARC Act by taking action here.
ABC Joins Call for Ban on Flavored Tobacco Products in NY
In September, the ABC joined the NAACP and other organizations in a letter to New York state officials asking for the passage of comprehensive policies to ban all flavored tobacco products, including menthol cigarettes. The letter highlighted the role flavored tobacco products play in perpetuating health care disparities, noting the tactics tobacco companies use to appeal to new audiences, especially Black communities, and potential smokers.

POLICY HIGHLIGHTS


Congress Improves Terms of Medicare Advance Payment Loans
Included in legislation to extend federal government spending through December 11, 2020 is language that improves the terms of Medicare advance payment loans that were made available to a broad group of Part A and Part B providers in March. Without action from Congress, providers who received an advance on their Medicare payments during the early months of the pandemic were facing a deadline to start repaying the loan this year or request an extended repayment plan at 10.25 percent interest.

Under the new terms, signed into law on October 1, the Centers for Medicare and Medicaid Services (CMS) cannot recoup payments providers received under the Accelerated and Advance Payment Program (AAP) Program until one year after the provider initially received funds through the Program. Once recoupment begins, the amount withheld from payment of new claims will gradually increase from 25 percent over the first 11 months of repayment to 50 percent for the six months following. Only at that point—or 29 months from the time a provider first receives a payment under the AAP— will interest accrue on any outstanding loan amounts at a rate of 4 percent.

Learn more here about the new repayment terms.
New Round of Provider Relief Announced
On October 1, the Department of Health and Human Services (HHS) announced it will disburse another $20 billion in CARES Act Provider Relief Funds. Under this Phase 3 General Distribution allocation, physicians who have already received Provider Relief Fund payments may apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Previously ineligible physicians, such as those who began practicing in 2020, will also be eligible to apply. Physicians will have until November 6, 2020 to apply for Phase 3 General Distribution funding.

Diversity and Inclusion: Central to ACC’s Mission, Vision, and Values
The American College of Cardiology (ACC) President Dr. Athena Poppas, Association of Black Cardiologist President Dr. Michelle Albert, ACC Past President Pamela S. Douglas and Ohio State University’s (OSU) Vice Dean of Faculty Dr. Quinn Capers IV authored a statement on diversity and inclusion in a recent JACC Journals leadership page.

 HEALTH EQUITY NEWS
Racial Discrepancies in Cardiovascular Outcomes
In an interview with HCPLive, Michelle A. Albert, MD, MPH, Professor in Medicine at the University of California at San Francisco (UCSF) and Director of the CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE (NURTURE Center), explained why this discrepancy exists and what can be done to close some of the gaps in cardiovascular health.
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Preventative Care Crucial in Cardiology
In part 2 of an interview with HCPLive, Michelle A. Albert, MD, MPH, Professor in Medicine at the University of California at San Francisco (UCSF) and Director of the CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE (NURTURE Center), explained how access to quality health care could be the most important factor in improving cardiovascular outcomes among minority patients.
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EXPERT ANALYSIS | Latest Evidence on Racial Inequities and Biases in Advanced Heart Failure
Khadijah Breathett, MD, shares the latest evidence on racial inequities and bias in advanced heart failure. “African-American women have the highest prevalence of heart failure.”
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Boston Scientific Takes On Systemic Racism To End Unneeded Amputations
Boston Scientific recently launched a new campaign marking the latest chapter in the company's Close the Gap health equity program. The medical device company has a plan to tackle systemic racism in healthcare, and to stop the "Black amputation epidemic.” MD+DI spoke with Boston Scientific's Camille Chang Gilmore and Jeff Mirviss to learn how the company is fighting systemic racism in healthcare. Gilmore is the company's chief diversity officer, and Mirviss is president of the peripheral interventions business.
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More HF Readmissions Among Black People From Deprived Neighborhoods
Back patients have greater 30-day heart failure (HF) hospital readmission rates than white patients that cannot be explained by CV risk factors or hospital characteristics, and instead are tied to living in socioeconomically deprived neighborhoods, new data suggest from a study presented by Alanna Morris, MD (Emory University School of Medicine, Atlanta, GA), during a late-breaking trial presentation at the Heart Failure Society of America (HFSA) Virtual Annual Scientific Meeting 2020.
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“These findings could serve as an aid to policymakers going forward in terms of allocating resources for primary healthcare. It's important [when] looking at these data and other[s] that we target heart failure patients who reside in deprived neighborhoods before, during, and post-hospitalization."

Keith C. Ferdinand, MD
Tulane Heart and Vascular Institute, New Orleans, LA

Quoted in “More HF Readmissions Among Black People From Deprived Neighborhoods”
Health and IT Coalition Forms To Tackle Inequalities in US
Healthcare providers and IT companies in the US have joined forces to form a coalition aiming to address longstanding health inequalities that have been amplified by the COVID-19 pandemic. The Consumer Technology Association (CTA)® and the Connected Health Initiative (CHI) have launched the Health Equity and Access Leadership (HEAL) Coalition, formed by private and public sector organisations including Best Buy Health, Boston Children’s Hospital, Google, Microsoft and Validic. The multi-sector initiative will create recommendations on the greater use of technology to mitigate health disparities, particularly coordination of resources, policy advocacy, research and education.
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 HEALTH CARE NEWS
New Bill Aims to End Racial Disparities in Amputations
Informed by a ProPublica article investigating why Black Americans were three times more likely to undergo diabetic amputations, five members of congress are working to fund screening and enhance diagnostics in an effort to save limbs.
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“Similar to COVID-19, peripheral artery disease care and outcomes can no longer be dictated by racism and zip code."

Michelle A. Albert, MD, MPH
President of the Association of Black Cardiologists

Quoted in “New Bill Aims to End Racial Disparities in Amputations"
Key Takeaways from Executive Order on Surprise Billing
In the Executive Order on An America-First Healthcare Plan, issued September 24, 2020, President Trump addressed, among other health care issues, the issue of surprise billing (also sometimes characterized as “balance billing”). The Executive Order is more of a messaging document than a substantive document, but does underline the continuing interest in the issue.
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US Senators Announce Health Equity and Accountability Act to Create a More Equitable Healthcare System
U.S. Senators Tammy Duckworth (D-IL), Mazie K. Hirono (D-HI), Richard Blumenthal (D-CT), Cory Booker (D-NJ), Ben Cardin (D-MD), Kirsten Gillibrand (D-NY), Tim Kaine (D-VA), Jeff Merkley (D-OR) and Bernie Sanders (I-VT) recently announced the Health Equity and Accountability Act (HEAA), legislation that would address health disparities among racial and ethnic minorities as well as women, the LGBTQ+ community, rural populations, and socioeconomically disadvantaged communities across the United States.
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 HHS NEWS
HHS Launching Effort To Better Track Office-Based EHR Use
The Department of Health and Human Services (HHS) is launching a program to revitalize data collection of and insights into office-based doctors' health IT use, the agency announced recently. The program, which will be run by the nonprofit medical group American Board of Family Medicine, will focus on software interoperability and burden on providers to inform future rulemaking.
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 MEDICARE NEWS
Health Groups Turn Up Heat on 2021 Medicare Fee Schedule
Physician groups and other healthcare providers continued expressing their dissatisfaction with the 2021 Medicare physician fee schedule proposed rule from the Centers for Medicare & Medicaid Services (CMS).
READ MORE

Regeneron recently launched an unbranded disease awareness website for Homozygous Familial Hypercholesterolemia (HoFH) called ThinkHoFH.com. The site is provided for general educational purposes and intended for healthcare professionals in the United States.

 INDUSTRY NEWS
Empagliflozin Cuts Risk of CV, Kidney Events in Heart Failure Regardless of CKD Status
New results from a recent major heart failure trial involving empagliflozin (Jardiance, Eli Lilly/Boehringer Ingelheim), the sodium glucose co-transporter 2 (SGLT2) inhibitor first developed to treat type 2 diabetes (T2D), show the drug works equally well to prevent renal decline regardless of their chronic kidney disease (CKD) status. Sub-analysis findings from the EMPEROR-Reduced phase III trial were presented at the American Society of Nephrology Kidney Week 2020 and published in Circulation.
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Inclisiran Effective Across FH Genotypes, as Well as in Primary Prevention
Inclisiran, an investigational small interfering RNA (siRNA) that inhibits production of the PCSK9 protein in the liver, significantly lowers LDL-cholesterol levels across a range of different genotypes of heterozygous familial hypercholesterolemia (HeFH), including patients with the severest forms of the disease, according to a new analysis of the ORION-9 trial. For a second study, an analysis of ORION-11, researchers reported that inclisiran was effective in lowering LDL cholesterol in patients without atherosclerotic cardiovascular disease (ASCVD). Both analyses were presented as late-breaking clinical trials at the virtual European Atherosclerosis Society Congress 2020.
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Learn How Patients Can Join the Heartline Study

How well do you know your heart? Johnson & Johnson, in collaboration with Apple, is offering eligible U.S. adults 65 years and older the opportunity to join the Heartline™ Study virtually from home using their iPhone.

The Heartline™ Study is a nationwide heart health research study designed to explore if the Heartline Study app on iPhone and heart health features on Apple Watch can enable earlier detection of an irregular heart rhythm known as atrial fibrillation (AFib), and potentially improve heart health outcomes, including reducing the risk of stroke.

As of October 9, 2020, eligible individuals with both Original (Traditional) Medicare and Medicare Advantage plans can now enroll in the Heartline™ Study. This expansion to Medicare Advantage opens enrollment for the Heartline™ Study to more than one-third (36%) of all Medicare beneficiaries enrolled in Medicare Advantage plans–about 24.1 million people.

This study is virtual. This means you can participate from anywhere through your iPhone- including from the comfort of your home, without having to go to a doctor’s office. You’ll participate in a heart-healthy engagement program with surveys, tips, and activities designed to help you become more engaged in your overall health. If you’re 65 or older and interested in being a part of the study, visit Heartline.com to learn more and download the app to see if you’re eligible to enroll.*

*Key eligibility criteria include: you must be 65 or older, a U.S. resident for the duration of the study, able to read/understand English, own an iPhone 6s or later (with iOS 12.2 or later), and have Original (Traditional) Medicare. Other eligibility participation requirements will apply.

 RESEARCH NEWS
ACE Inhibitor Use Prior To Hospitalization Boosts Survival For COVID-19 Patients
Hospitalized COVID-19 patients who were already taking angiotensin-converting enzyme (ACE) inhibitors have a reduced risk of mortality, according to new findings published in the Journal of the American Heart Association.
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New 'Atlas' of Human Heart Cells First Step Toward Precision Treatments For Heart Disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in new research published in the journal Nature. Cardiologists from the Mazankowski Alberta Heart Institute at the University of Alberta joined teams from Cambridge, Boston and Berlin to use state-of-the-art analytical techniques to sequence the ribonucleic acids (RNA) in nine types of single cells from six regions of the heart.
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Grant Funds Research into Pharmacy Community Health Workers
The University of Buffalo has received a grant to better understand how to deploy community health workers in the pharmacy setting. The grant, issued by the Community Pharmacy Foundation, aims to understand how community health workers can function within the pharmacy setting specifically, as well to develop payment modalities for community health workers.
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 HEALTH TECH & TELEMEDICINE
16 Big Trends in Health IT Today
During the pandemic, clinicians transitioned their practice to virtual care, and a large portion of the workforce began to work remotely. Healthcare providers were hit hard financially during the early waves of the pandemic and now many are turning to technology to become more efficient and cost-effective. During the Becker's Health IT + Revenue Cycle Virtual Event, experts from across the U.S. discussed the biggest opportunities and threats for healthcare providers today. Here are 16 takeaways from the event.
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Patient Satisfaction with Telehealth High Following COVID-19
Telehealth is one of the top health sectors yielding a high patient satisfaction score, but just about half of patients are still citing some barriers to virtual care access, according to the J.D. Power 2020 US Telehealth Satisfaction Study. Although telehealth has been around for years, it has seen its biggest use case during the COVID-19 pandemic.
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 ANNOUNCEMENTS



National Forum Recognizes ABC During Annual Meeting

The ABC was honored with the 2020 National Forum Heart Healthy Stroke Free Award during the National Forum for Heart Disease & Stroke Prevention 18th Annual Meeting. The Forum annually recognizes individuals and organizations who have made exceptional contributions to heart disease and stroke prevention during its annual meeting. All awardees were “highlighted” during the annual virtual summit.

Congratulations to Clyde Yancy, MD for being honored with the Commitment Award for outstanding contributions to the National Forum.





Surgeon General Launches Call to Action
on Hypertension Control

The CDC recently released The Surgeon General’s Call to Action to Control Hypertension, which summarizes recent data, identifies goals and strategies to accelerate national efforts, and outlines how different sectors, beyond public health and governmental agencies, can work together to promote control across all populations. The Call to Action bolsters HHS’s Healthy People 2030 goals to increase hypertension control among adults, while also promoting and identifying proven strategies that can be replicated, adapted, and scaled across diverse settings. The report outlines three goals to support improvement, each with strategies to accelerate progress.

LEARN MORE

Call for Abstracts
2021 Dr. Jay Brown Best Abstract Competition


Submit your abstract summarizing any problem that relates to cardiovascular disease whether it is: Clinical, Basic or Population Science. Abstract must be original scientific research and must not have been published previously. Any physician/scientist presently in a residency or cardiology fellowship training program and active in the Association of Black Cardiologists is eligible. Not an ABC member? Click here to join or renew.

Four (4) outstanding abstracts will be selected. The winner of the Dr. Jay Brown Best Abstract Competition will also receive a $1,000 cash award. Deadline to submit your abstract is January 15, 2021.

Deadline: January 15, 2021

SUBMIT HERE

Call for Submissions
Racial Disparities in Healthcare Issue June 2021


Circulation welcomes the submission of Original Research Articles focusing on disparities in healthcare for Black people. All submissions will receive consideration for simultaneous publication in June 2021. This is a themed issue focusing on disparities that will be led by Mercedes Carnethon, PhD, and Karol Watson, MD, PhD, both Circulation Associate Editors and Michelle Albert, MD, MPH, President of the Association of Black Cardiologists, Circulation Editorial Board member and Associate Editor of ATVB, serving as Guest Editor.
Deadline: January 6, 2021

MORE INFO

 UPCOMING EVENTS






Towards Legitimacy and Results in Achieving Diversity, Inclusion and Belonging in Cardiology Training Programs: A Program from the Association of Black Cardiologists

Join ABC for this first of its kind Cardiovascular Workforce Program which includes directors of leading cardiovascular medicine fellowship programs. This ABC webinar will highlight contemporary issues impacting the recruitment of Blacks and Hispanics in cardiovascular medicine and identify potential solutions to the crisis.

Thursday, October 29
12:00 PM – 1:30 PM EST / 9:00 AM PST - 10:30 AM PST


REGISTER TODAY



The Community Physicians’ Network
Clinical Trial Workshop Series

Our goal is to eliminate health disparities through excellence in quality healthcare. Our research areas of interest include: Diabetes, Cardiovascular Disease/Stroke Hypertension, Cancer, Obesity, Sleep Disorders, Women’s Heath, Child and Adolescent Health, HIV/AIDS, Asthma, Arthritis, and Chronic Obstructive Pulmonary Disease.

In addition to research, we provide the following services developing and providing electronic data standard for quality reporting, real-time disease specific registries to support quality reporting, access to innovative patient-centered technologies for health, wellness, and chronic disease management, educational workshops, expert roundtables and continuing medical education (CME).

Join Today! Membership in the Community Physicians’ Network (CPN) is free. For more information and to join, please contact Debra Teague, Program Manager, 404-756-5051. Once you have registered, Debra Teague will send out a zoom invite to include the agenda.

October 31, 2020
8 AM - 12 PM EST


REGISTER



Spirit of the Heart Community Forum and Wellness Symposium: An Interactive Virtual Event

On November 14, the ABC will host its first virtual community health event, hosted by ABC members in Orange County, California, with Celebrity Actor and Community Advocate Lamman Rucker as a special guest. This Spirit of the Heart Community Forum and Wellness Symposium will include a discussion session with physicians, policymakers, clergy and health advocates along with health & wellness segments on healthy eating & nutrition, telehealth tips, and COVID-19 and Cardiovascular Disease.

Saturday, November 14
10:00 AM – 2:30 PM PST


REGISTER NOW

Supported, in part, by Amgen, AstraZeneca, and Edwards Lifesciences
Amazon has proudly partnered with the Association of Black Cardiologists (ABC) through its AmazonSmile program. If you select ABC as your designated charity while shopping on Amazon.com, the AmazonSmile Foundation donates a portion of every purchase to ABC.

When you shop at smile.amazon.com, you'll support ABC too!

Click here to support ABC through your purchases on Amazon or AmazonPrime!






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