Dear FCACC Member:   At the last Board of Governors meeting we heard that all efforts to influence change in the 2010 CMS Rule has been futile in an atmosphere consumed with Health Care Reform legislation. The ACC is not giving up its efforts but has decreased the intensity of its approach. As we watch this dysfunctional Congress inability to deal with the SGR fix we know that our problem is invisible to them. The SGR is an item that organized medicine has dedicated years of intense lobbying to fix and change and yet Congress just postpones any action. On top of a 2010 CMS Rule which will continue until 2013 decreasing our payments CMS will be publishing its 2011 Rule this summer which will likely include new bundled codes for cardiac catheterization and peripheral angiography. This only means more cuts in payments from Medicare. The Obama administration announced the nomination of Don Berwick, MD, to head CMS and no doubt he was chosen to continue an agenda of government savings by decreasing payment to physicians. Rampant panic, with good reason, is the prevalent sentiment in cardiology. The ACC predicts up to 50% of Cardiology Practices will integrate with Hospitals by the end of 2010 either in full integration or partnership agreements. As President of the Florida Chapter, although committed to fight for the survival of the independent private cardiology practice, I find very difficult to maintain an optimistic attitude. Yet more than ever I know the importance of this fight. We are fighting for the basic American values of small business – the entrepreneur spirit that makes this country great. We are fighting so that our children have the same opportunity to live the American dream. My concern, which I expressed at the Board of Governors of the ACC, is that the majority of cardiologists and Americans fail to appreciate what they have, they take it for granted and don’t have the guts and commitment to fight for it. This summer we will continue to take our message to Congress and we will point out to them how they are allowing the change of our health care system by the present Administration, and the consequences of these changes. We will announce actions to be taken during the future Congressional breaks. As many of you integrate with Hospitals be aware that it is an experiment that could indeed fail.  I hope you will continue to fight with us so that you and your children have a better opportunity again in the future. Next SEPTEMBER 12-14 I want as many Florida Cardiologists as possible to come for the Legislative Conference at the ACC. Information is available at www.acc.org under advocacy. This will give us the opportunity to inundate Congress with ANGRY, IRATE Cardiologists to carry a strong message to Congress.     Alberto Montalvo, MD, FACC Florida Chapter, American College of Cardiology