From Your Chapter President   Nancy, Paul and I have just returned from the Board of Governors’ Meeting and the 2009 Leadership Conference with ideas and enthusiasm for the Chapter. We met with ACC leaders and heard from the President Elect, Al Bove. He spoke of the “year of the patient,” and the ACC goal of taking its quality initiative further by applying our guidelines to reduce health care costs, but not sacrificing the quality of care and access to new technology.  We must move forward as a profession, advocating for our patients as healthcare reform begins and medicine changes. To quote Dr. Weaver, “Change is here, we must accept it, and move on.”    To this end, we will be engaging our councilors and membership to promote advocacy and quality. The Advocacy Committee should be preparing for out State Legislative Day on 03/03/2009, and the ACC Legislative Conference on 09/13/2009. Our local issues of malpractice reform, inability to attract physicians in Upstate New York, imaging regulation and a louder voice in the rules dictated by health plans have to be kept in the forefront. We need personal access to our State senators and assemblymen to make them aware of our professional needs.  Healthcare reform will be discussed in the upcoming months and we must as cardiologists as well as members of the House of Medicine voice our opinion.   We must also promote quality through our State Chapter. Our surgical, invasive and interventional colleagues are leaders in data generation and outcomes. We must find a way to more fully apply our noninvasive and procedural guidelines more completely to physician ordering and patient care.  This is where we need to improve our professionalism from a grass roots level.  Evaluating ourselves, educating our peers and referring physicians in state-of-the-art cardiovascular care needs to be taken to a higher more encompassing level. Recently, a New York Times health article  (Personal Health Profile; More Isn’t Always Better in Coronary Care, 01/06/2009) emphasized what probably should be our mission. The article clearly outlined misuse of invasive testing and revascularization, embarrassing our profession as it deviates from its own guidelines. Hopefully, our Quality Committee can work to strengthen our ability to apply guidelines and measure outcomes. The new administration in Washington is committed to health information technology and we should utilize all resources available to promote this goal.    I would like to give special praise to the New York City Health Commissioner, Thomas Frieden, for addressing the problem of too much dietary salt. As you will remember, Dr. Frieden spoke at our annual meeting in 2007. He has taken on smoking, transfats and calories. He has now undertaken a mission to reduce sodium in our diets. Going beyond the salt shaker, he is looking to reduce salt ingestion by 20% over the next five years by working with producers of processed food to reduce salt content. Think of the health benefit! We should do everything to work with Dr. Frieden to advance his cause. The Chapter is supporting his efforts. Behind our assault on salt: City health commissioner defends his controversial new crusade.    Also, please think of the ACC/PAC (Political Action Committee) for 2009.  If we could all personally contribute just $100, our approximately 2200 members would make a tremendous impact. Others want to shape healthcare and we need to continue to promote professional cardiovascular care through advocacy. We cannot get run over by the train to healthcare reform. Last month, I met with Congresswoman Gillibrand who is now Senator Gillibrand.  She is most interested in healthcare and wants further direction from physicians. She is a receptive representative with whom we can interact. Unfortunately, in our political system, access to politicians requires money. Allow our leaders to continue dialogue by supporting the ACC/PAC. Join the ACC PAC today!   This is my last column as President of the New York State Chapter of the American College of Cardiology. After the meeting in March in Orlando, Florida, Drs. VanTosh and Bisognano will replace Paul and me as the Governors in New York State and the President of the New York State Chapter and The New York Cardiological Society. Working with Paul has been a privilege and we look forward to a continued role in the Chapter.    Also, a special thanks to Nancy for her undying enthusiasm and support.  We have a strong Chapter that needs participation. As a professional society cornered in education for its members, quality care for its patients and advocacy for the best cardiovascular care in the world, we should be enthusiastic and anxious to participate. During my three years as Upstate Governor for the American College of Cardiology, I have learned much about the national organization and our State organization.This has reaffirmed my professional interest in medicine and cardiovascular care. I look forward to continuing to support their ongoing efforts.     Harry C. Odabashian, Jr., MD, FACC   2009 Arvilla Berger Lecture Bradford C. Berk, MD, PhD, FACC   Bradford C. Berk, MD, PhD, FACC, has been invited to deliver the Thirty-Sixth Annual Arvilla Berger Lecture. Dr. Berk is Senior Vice President for Health Sciences and CEO of the University of Rochester Medical Center and Strong Health. He is Professor, Department of Medicine, Department of  Pathology and Laboratory Medicine and Department of Pharmacology and Physiology. The title of Dr. Berk’s lecture is, Plaque Erosion And Eruption:Biomarkers As Seismic Predictors. The target audience is cardiologists, general internists, cardiology fellows, internal medicine residents and community family practitioners.   The lecture will be presented at the University of Rochester Medical Center on Tuesday, March 10, 2009 at 8:00 a.m.  Additional information will be sent to you via e-mail. You may also call the New York State Chapter office at 212.686.0028.

Legislative Day Join your colleagues in demanding medical liability reform by participating in the New York State Legislative Day on Tuesday, March 3, 2009. This is an opportunity for you and your colleagues to let your legislators know your concerns regarding the uncontrollable cost of medical liability insurance, the difficulties which you experience from the health plans in your attempts to assure necessary patient care, the inability to receive fair and timely reimbursement and many other issues. Last year a record number of physicians participated in the New York State Legislative Day. For additional information, contact the Medical Society of the State of New York at 518-465.8085 ext. 312 or 320.         Economic Stimulus Package Includes $19B for Health Information Technology   Included in the economic stimulus package is $19B for health information technology. The Congressional Budget Office estimates that approximately 90 percent of physicians and 70 percent of hospitals will utilize comprehensive electronic health records as a result of the bill.   There are four main components to the HIT package: (1) development of standards for HIT through the codification of the National Coordinator for Health Information Technology which will oversee the work of a newly created HIT Policy Committee and HIT Standards Committee, which will develop policies for the development respectively of an infrastructure to support a nationwide health information network and standards and certification criteria for electronic exchange (2) immediate funding to strengthen the HIT infrastructure through planning and implementation grants and investment training of medical informatics workers to support the use of  HIT (3) encouraging the adoption of HIT by providers through grants to states for low-interest loan programs and the inclusion of payment incentives to physicians through Medicare beginning in 2011 and by the subsidization of high-volume Medicaid providers beginning in 2011 (4) strengthening of privacy protections for electronic health information by applying security provisions and penalties of HIPPA to business associates of covered entities and requiring notice to patients if their medical information is breached and requiring an accounting of disclosures of health information made through HIT systems.     Settlement with UnitedHealth Group   The office of the New York State Attorney General has reached an agreement with UnitedHealth after conducting an industry-wide investigation into a scheme to defraud consumers by manipulating the usual , customary and reasonable (UCR) reimbursement rates. At the center of the controversy is Ingenix , a wholly-owned subsidiary of UnitedHealth. Ingenix is the nation’s largest provider of health care billing information.   Under the agreement , the database of billing information operated by Ingenix will be closed. UnitedHealth will pay $50 million to a qualified nonprofit organization to establish a new , independent database. This database will be used to help determine fair out-of-network reimbursement rates for consumers throughout the United States . According to the American Medical Association , the settlement is subject to preliminary approval by a federal district court in New York . No distribution of the settlement funds will take place until final court approval has been obtained following a “fairness” hearing.     2009 Medicare Fees on Website   The 2009 Medicare Fee Schedule and Limiting Charge information has been posted to the National Government Services website. To access this information go to: http://www.ngsmedicare.com  and click on the following: Click on Part B on Drop Down menu, Click on New York on Drop Down menu, Click on Accept on Attestation page, Click on Fee Schedules on Quick Links page. These files include the fees and limiting charges effective for services rendered on or after January 1, 2009.     E-Prescribing Vendor Purchases Caution Advised   Recent reports have alerted us to the fact that caution should be used in dealing with certain offers from vendors regarding E-Prescribing software.    A number of vendors, in conjunction with major health insurers, are soliciting physicians to purchase software packages that will allow them to take advantage of the new E-Prescribing initiative. This effort is being pushed by the federal government through Medicare and, now, has found its way to the private sector. More and more packages, some with very attractive features, are being touted.   It is important that physicians be aware of the fact that a number of these packages include a provision, not always advertised in the promotional material, requiring the physician to permit access to patient records/database via an on-line connection. Physicians should use caution in this regard and research the particulars before signing any contract or agreement to purchase and install such software.           A Clinician’s Guide to e-Prescribing   The Centers for Medicare and Medicaid Services (CMS) has released, A Clinician’s Guide to e-Prescribing. This is the first comprehensive , multi-stakeholder-informed how to guide to assist physicians make informed decisions about how and when to transition from paper to electronic prescribing systems. The guide also provides a list of key references and resources which readers may consult to help make the transition to e-prescribing as smooth as possible. To download a copy of the guide go to: http://www.ehealthinitiative.org/assets/Documents/e-Prescribing_Clinicians_Guide_Final.pdf         Cooling Therapy for Cardiac Arrest Effective January 1, 2009, New York City ambulances began taking many cardiac arrest patients only to hospitals that offer cooling therapy, even if it means bypassing closer emergency rooms. New York City joins a handful of other American cities, including Seattle, Miami, and Boston, in requiring transport to hospitals with cooling systems.     Primary Care Physician Shortage: 2% of Medical Students to Enter Field   According to a study published by the American Medical Association, two percent of medical students plan to practice general internal medicine. Cited in the study is the fact that general internists provide a large portion of care for older patients and people with chronic illnesses. While the number of older United States residents is expected to nearly double between 2005 and 2030, the number of medical students planning to become general internists is declining. Quality of life factors such as income and work hours appear to influence the medical students’ decision not to practice general internal medicine.   Upcoming Meetings   Thirty-Sixth Annual Arvilla Berger Lecture PLAQUE EROSION AND ERUPTION:  BIOMARKERS AS SEISMIC PREDICTORS Bradford C. Berk, MD, PhD, FACC Tuesday, March 10, 2009 University of Rochester Medical Center Rochester , New York   ACC >09 Sunday, March 29 - Tuesday, March 31, 2009 Orlando, Florida   CARDIOLOGY AT MOHONK Saturday, April 18, 2009 Mohonk MountainHouse New Paltz , New York   17th Annual DIAGNOSIS AND MANAGEMENT OF CARDIAC ARRHYTHMIAS Saturday, May 2, 2009 The Princeton/Columbia Club of New York New York City   SECOND ANNUAL CARDIAC CARE ASSOCIATE SYMPOSIUM 2009 Friday, June 5, 2009 New York Athletic Club New York City   81ST ANNUAL SCIENTIFIC SESSION THE NEW YORK CARDIOLOGICAL SOCIETY 19th ANNUAL MEETING NEW YORK STATE CHAPTER, ACC Saturday, October 3, 2009 New York Athletic Club New York City     Up-to-date meeting information appears on the New York State Chapter website www.ny-acc.org