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2012
Society Details Lessons Learned in the CED Process (1/20/2012) — In response to the Centers for Medicare and Medicaid Services’ request for input on the coverage for evidence development (CED) policy, the Society submitted comments on how to improve the Agency’s process. Learn more »
2011
CMS Releases ACO Proposed Rule (4/6/2011) — On March 31, the Centers for Medicare & Medicaid Services (CMS) released the long-awaited proposed rule on Accountable Care Organizations (ACOs). The health care reform law established a Medicare shared savings program that seeks to reduce costs and increase quality of care by allowing a group of providers, gathered into an ACO, to enter into a three-year contract under Medicare, which will provide coordinated care to fee-for-service beneficiaries. The Society has summarized this proposed rule, which explains the various requirements to become an ACO. Learn more »
CMS Revises Policy on MRIs for Patients with Pacemakers and ICDs (3/23/2011) — Last month, the U.S. Food and Drug Administration approved the first heart pacemaker designed to be used safely during certain magnetic resonance imaging (MRI) exams — Medtronic's Revo MRI SureScan Pacing System. As a result, the Centers for Medicare and Medicaid Services (CMS) has updated its reimbursement policy and will now allow coverage when beneficiaries are enrolled in CMS-approved clinical studies seeking additional evidence about the utility and safety of MRI exposure. Learn more »
EP Specialty Designation Implementation Postponed (2/23/2011) — The Centers for Medicare and Medicaid Services (CMS) announced a delay in the implementation of a new physician specialty code for electrophysiology, stating the previously released date was an inadvertent mistake. The effective date is July 1, and the implementation date is July 5. The Society will continue to monitor CMS's goals for implementing the new physician specialty code for eventual use. Learn more »
2010
Medicare PECOS July 6 Enrollment Deadline Postponed (07/07/2010) — The Centers for Medicare & Medicaid Services (CMS) recently announced that it is working with providers to address concerns about the July 6 deadline for enrollment in the Provider Enrollment, Chain and Ownership System (PECOS) database. While the regulation will be effective July 6, physicians that list the name and NPI of a referring/ordering physician who is not yet enrolled in PECOS will not receive claim denials beginning on that date — for now, claims will continue to be reviewed and paid as they have been. Learn more »
UnitedHealthcare's New Prior Notification Policy (06/16/2010) — Beginning July 1, Society members that participate in UnitedHealthcare and its family of reimbursement programs in the states of Florida, Missouri, North Carolina, Ohio and Wisconsin will be required to obtain prior notification before performing certain pacemaker and ICD implantation procedures. (The prior notification program will begin in most other states on September 1.) Prior notification is required for elective or emergent procedures and failure to comply with the requirement will result in an administrative denial. The Society worked closely with UnitedHealthcare to ensure that the clinical criteria for the prior notification program are consistent with the Society's consensus statements and practice guidance. Learn more and download guidelines »
PECOS Enrollment Deadline Moved Up to July 6 (06/16/10) — CMS announced that the deadline for referring or ordering physicians to enroll or update their enrollment status in the Provider Enrollment Chain and Ownership System (PECOS) will be moved up to July 6, 2010. Earlier this year, CMS had extended the enrollment deadline to January 1, 2011 to allow physicians to enroll or update their Medicare status in PECOS. With the passage of the Patient Protection and Affordable Care Act, that deadline was advanced. Learn more »
2009
Medicare Provider Enrollment, Chain and Ownership System (PECOS) Policy Changes Delayed for 2010 (12/22/2009) — On October 5, 2009, the Center for Medicare and Medicaid Services (CMS) began implementing the first phase of a new policy under which Medicare would not pay claims for services when the referring or ordering physician or health care practitioner is not in the Provider Enrollment, Chain and Ownership System (PECOS) database. CMS announced the policy in Change Requests 6417 and 6421. Learn more »
Update on September MedPAC Meeting (09/23/2009) — The Medicare Payment Advisory Commission (MedPAC) held a two-day public meeting September 17-18 in Washington, DC. The agenda included discussions and presentations regarding the context for an upcoming chapter on Medicare Policy, comparative effectiveness and episodes of care that account for the greatest share spending and fastest growth of Medicare. Learn more »
2007
Washington Report: Modifier-51 (11/02/2007) — Heart Rhythm Society wrote a letter to members to make them aware of a change in the Modifier-51 that will take effect on January 1, 2008, which will result in a change in reimbursement for EP studies and ablation procedures from Medicare and eventually all private insurance third-party payers. Learn more »
Washington Report: Heart Rhythm Society Successes with NCCI and MUE Challenges (06/13/2007) — The Society prevailed in its objection to the National Correct Coding Initiative (NCCI), Version 13.3 edits scheduled to take effect on October 1, 2007 by convincing the Centers for Medicare & Medicaid Services (CMS) to defer action on implementation. Learn more »
2005
APC Advisory Panel's Recommendation to CMS (08/26/2005) — The Centers for Medicare and Medicaid Services (CMS) hosted a meeting of the Advisory Panel on Ambulatory Payment Classification (APC) Groups. The discussion included two specific APC groups, 0107 Implantation of Cardioverter-Defibrillator and 0108 Insertion/Replacement/Repair of Cardioverter Defibrillator Leads and Insertion of Cardioverter-Defibrillator, which have a direct impact on heart rhythm procedures performed in the outpatient setting. Learn more »
American Medical Association (AMA) letter to Congress voices opposition to extension of 18-month moratorium on physician referrals to specialty hospitals (06/10/2005) —On April 22nd, 2005 the American Medical Association (AMA) sent letters to the Speaker of the House J. Dennis Hastert and Senate Majority Leader Bill Frist, MD, expressing support for physician-owned specialty hospitals. Learn more »
