December 2006 Aetna Announces Changes to Radiology Precertification Program On December 1, 2006 Aetna notified physicians and administrators of changes in its radiology precertification program, effective March 1, 2007. On that date MedSolutions (MSI) will assume responsibility for precertification for all high-tech outpatient diagnostic imaging procedures for all additional Aetna commercial health benefits plans except indemnity Traditional Choice® plans. Precertification will be required for the following: MRI/MRA PET Scan Nuclear Cardiology CT Scan Services Impacted are: Inpatient radiology services Emergency Room radiology services Outpatient radiology services other than MRI/MRA, CT Scan, PET Scan and Nuclear Cardiology Precertification services should be directed to MedSolutions at 1-888-693-3211 or by fax at 1-888-693-3210, Monday through Friday, during normal business. Requests can also be made via their website, www.MedSolutions.com. Please do not call Aetna for precertification for these services. Questions should be directed to Aetna Provider Service Center at 1-800-624-0756 and select the "Medical Precertification" option. For PPO-based plans, please call 1-888-MD-Aetna (1-888-632-3862), and select the "Medical Precertification" option. Feel free to share these changes with your practice administrator. 2007 Medicare Cuts - A Pocketbook Issue Congress will recess on Friday, December 8, or perhaps the next day. Still on its docket is a decision on whether Medicare physician payment will face a five percent cut effective January 1, 2007. In recent weeks, the Illinois Chapter has sent all-member emails stressing the importance of contacting members of congress to urge action on the physician payment issue which would stop the 2007 physician payment cut. According to ACC, Illinois cardiologists are bringing the issue to their members of congress by phone, email, and letter. In lieu of a 2007 payment cut, one possibility is to continue Medicare payments at current levels without increases or, in some cases, to provide a small increase in payments — selectively or generally. The Illinois Chapter is grateful to those of its members who took the time and effort to reach their national legislators on this pocketbook issue. IHFPB Cardiology Services Document Under Chapter Review The Illinois Health Facilities Planning Board (IHFPB) is in the process of drafting guidelines in four areas of cardiology services. They are: cardiac surgery, diagnostic cardiac catheterization, interventional cardiac catheterization, and electrophysiology. An Illinois Chapter review group led by Dr. David J. Hale, Immediate Past President of the Chapter, is at work closely examining the issues effecting cardiology services outlined in this draft document. A letter to the Planning Board addressing problems encountered and providing suggestions for improvement will be sent prior to a Friday, December 15 meeting being held to collect comments. Because of the draft nature of the document the Chapter is unable to provide wide distribution at this time. A notice to all Chapter members will be sent regarding the current status of discussions. Illinois & Door-to-Balloon (D2B) Whether you call it D2B or Cardiac Alert Program, there are several ongoing efforts to establish a D2B through emergency cardiac care services provided by hospitals.  At the national level, ACC and the American Heart Association (AHA) unveiled a number of strategies that hospitals need to implement for D2B: ED physician activates the cath lab One call activates the cath lab Cath lab team ready in 20-30 minutes Prompt data feedback Senior management commitment Team-based approach In Illinois, a cardiac alert program directed by Dr. Peter Kerwin, Advocate Good Samaritan Hospital, featured ambulance and emergency team personnel speakers, who discussed implementation of a D2B program within a 60 minute timetable. The ACC/AHA recommends establishing a 90 minute period, recognizing that the program is new and that there are many variations that affect achievement of this goal and ultimately lowering it. The Illinois Chapter is in the process of completing a grant application to a major pharmaceutical company for support of a D2B program.  Chapter members can assist the Chapter effort by bringing D2B strategies and program implementation to the attention of the appropriate cardiac emergency channels within their institution. Dr. Peter Kerwin also hosted a 60 minutes teleconference on reducing time to infarct angioplasty which has been recorded and made available for later viewing online in the AHA Get with the Guidelines Web conference archive.