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Legal Actions

After exhausting all immediate regulatory and legislative options – and with no final action by Congress or CMS to stop the cuts prior to the Jan. 1, 2010, deadline – the College on Dec. 28 filed a complaint, as well as motions for a preliminary injunction and expedited discovery, against Health and Human Services (HHS) Secretary Kathleen Sebelius, in U.S. District Court in Florida. The complaint alleged that Sebelius, in her capacity as HHS secretary, unlawfully adopted the payment rates for cardiology services in the 2010 Medicare Physician Fee Schedule in a manner that threatens access to patient care and precipitously increases Medicare costs. According to the complaint, clear and critical defects exist within the Physician Practice Information Survey (PPIS), which was used to justify cuts to Medicare reimbursements rates for cardiology and which directly undermine the viability of community practices.The complaint sought a preliminary injunction against the implementation of the 2010 Fee Schedule and asked the court to rule it invalid and order HHS to commission a new practice expense survey.

However, ACC's motions were denied on jurisdictional grounds in early January, with a judge finding that statutory language governing the Medicare program precludes judicial review of the relative value units and the methods for determining the RVUs in the Medicare fee schedule. A blow to physicians everywhere, the court decision only serves to emphasize the precedent that CMS can set physician payment in whatever manner it chooses regardless of impact and/or level of analysis

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* For more information on the legal filings, contact advocate@acc.org.

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