Lieb, David--IMPACT

I am writing in response to your recent proposal which will result in, by the calculation of our professional associations, a 42% drop in reimbursement for office-based cardiac ultrasound examinations. Cardiac ultrasound has become a vital part of the diagnostic process in patients presenting with cardiac and potentially cardiac disease entities. The examination is required by numerous professional guidelines and quality initiatives, often with government endorsement. I perform this procedure as a noninvasive cardiologist in my office and I interpret these studies for a local community hospital and a major academic medical center. I am a former medical director of an academic cardiac ultrasound department. I know the cost entailed in providing this service. In no uncertain terms, I will be unable to continue this part of my practice and I forsee significant changes in the availability of this service to Medicare beneficiaries if these cuts are allowed. The reimbursement for these services has continually declined over the past 10 years. To proceed further at this rate is irresponsible and will have grave consequences.