Campaign for Patient Access
Medicare Cuts Threaten Patient Access
In late 2009, the American College of Cardiology identified a looming crisis: proposed cuts to the Medicare Physician Fee Schedule threatened to undermine cardiology practices across the country. These cuts, if implemented, would have made it financially unsustainable for many practices to continue serving Medicare patients at current levels.
Cardiologists in Fort Myers, Chicago, Birmingham, Delaware, and communities nationwide warned that their practices would be forced to scale back or eliminate services — directly impacting seniors' ability to receive timely, life-saving cardiovascular care.
The Physician Practice Information Survey (PPIS)
At the center of the controversy was the Physician Practice Information Survey, a data source used by the Centers for Medicare & Medicaid Services to set payment rates for the 2010 Medicare Physician Fee Schedule. The ACC argued that the PPIS was fundamentally flawed and invalid, and that the resulting fee schedule rule was arbitrary and capricious — an abuse of agency discretion that would harm both physicians and the patients they serve.
Why It Mattered
The Medicare payment system directly affects whether cardiology practices can afford to keep their doors open to Medicare beneficiaries. When reimbursement rates fall below the cost of providing care, practices face difficult choices:
- Reducing the number of Medicare patients they can accept
- Eliminating certain services or closing satellite offices
- Delaying investment in life-saving technology and equipment
- In the most severe cases, closing the practice entirely
For the millions of Americans who rely on Medicare for cardiovascular care — including treatment for heart disease, the nation's leading cause of death — these cuts represented a direct threat to their health and well-being.
The National Picture
Reports from across the country painted a consistent picture. In December 2009, cardiologists in Fort Myers, Florida, publicly warned that many practices planned to scale back or eliminate services due to the 2010 Medicare cuts. Similar warnings came from Chicagoland cardiologists, Birmingham specialists, and Delaware cardiac care providers — all describing the same threat to patient access.
These local stories, amplified by coverage in Kaiser Health News, the Philadelphia Inquirer, and other outlets, helped build a national understanding of what was at stake. The Campaign for Patient Access brought these voices together to press for legislative, regulatory, and legal remedies.