Medicare $$ Up for Cardiology in 2017

By SCMA On 04/08/2016  

Medicare Payments Up for Cardiology in 2017. Cardiology inpatient reimbursement will gain 2.7% overall compared with the prior year, as the Centers for Medicare & Medicaid previously proposed.

An increase in Medicare payments for cardiovascular procedures, particularly mitral valve repair with MitraClip and left atrial appendage closure (LAA), were confirmed in a final rule for fiscal year 2017.

Cardiology inpatient reimbursement will gain 2.7% overall compared with the prior year, as the Centers for Medicare & Medicaid previously proposed. The new rates go into effect Oct. 1, 2016.

However, that average increase just keeps pace with the cost of living increase over the same period, translating to a "neutral change or a slight paycut," Kim A. Williams, Sr., MD, of Rush University Medical Center in Chicago and immediate past president of the American College of Cardiology, told MedPage Today when the proposal was first made.

The bill that repealed the sustainable growth rate payment formula -- the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) -- specified an overall 0.5% increase in physician fees each year through 2019, but some specialties have gained substantially more.

Among the specific winners and losers in the final rule, the final rule confirmed that MitraClip will no longer get a new tech add-on payment but instead move to a higher paying category, with a weighted average reimbursement of $34,586, up from $31,000 previously.

The reassignment "will make hospital MitraClip programs sustainable," devicemaker Abbott said in a statement.

LAA closure -- for which only the Watchman device is approved -- lost a little (0.2%) compared with the initial proposed reimbursement but still will gain 5.3% over the reimbursement levels for fiscal year 2016.

Ventricular assist device reimbursement rose 1.9% in the final rule from what had been proposed, for a total 5.1% increase over 2016.

Other changes were:

• Carotid stent reimbursement was down 0.3% from what had been proposed but still up 4.3% from 2016.
• Implantable cardioverter defibrillators and pacemakers lost 0.5% and 0.1%, respectively, from what had been proposed but are still up 1.3% and up 1.1%, respectively, from 2016.
• Non-transcatheter heart valves lost 0.1% compared with the proposal but gained 3.2% over 2016.
• Transcatheter aortic valve replacement lost 0.7% from the proposal and 1.2% compared with 2016.

The rule also extended the new tech add-on payment period for the CardioMEMS monitoring device and for the Lutonix and Admiral drug-coated balloons through the end of the 2017 fiscal year.

Tagged with: Medicare, Cardiology