CBO’s Estimated Cost Of Freezing Medicare Physician Pay Edges Up Again
January 26, 2015
The goals CMS set Monday (Jan. 26) for moving providers to alternative pay models and value-based payments make it all the more important for physicians that Congress pass Medicare physician pay reform, provider lobbyists said, because Congress can pay doctors extra for simply participating in alternative pay models and CMS cannot. Last year’s bipartisan Sustainable… more
U.S. to Overhaul Medicare Payments to Doctors, Hospitals
January 26, 2015
The Obama administration will make historic changes to how the U.S. pays its annual $3 trillion health-care bill, aiming to curtail a costly habit of paying doctors and hospitals without regard to quality or effectiveness. Starting next year Medicare, which covers about 50 million elderly and disabled Americans, will base 30 percent of payments on… more
Agreement Between Lawmakers, Stakeholders On ‘Doc Fix’ Offsets Remains Elusive
January 22, 2015
Providers and lawmakers agreed that the sustainable growth rate (SGR) formula for determining Medicare physicians’ reimbursement needs to be permanently fixed, but during a Jan. 22hearing, they offered no new ideas on how to pay for it. Representatives from hospitals, physicians and nursing groups told members of the House Energy and Commerce health subcommittee they… more
CMS Expected To Announce Plans To Speed Performance-Based Pay
January 22, 2015
CMS officials are expected to announce Monday (Jan. 26) that they are moving a certain percentage of Medicare provider contracts to performance-based pay in the near future, provider lobbyists say. The expected announcement coincides with work Congress is doing to reform the Sustainable Growth Rate (SGR) formula, which calls for moving physicians to alternative pay… more
‘Doc Fix’ Hearing Yields Familiar Talking Points
January 21, 2015
Lawmakers kicked off a two-day hearing on the perennial question of how to forestall Medicare’s physician payment cuts Wednesday by discussing how to pay for a compromise struck in the 113th Congress. But prospects for a package of offsets that could satisfy both parties remained murky. Neither Democrats nor Republicans moved much beyond their talking points… more
MedPAC seeks reimbursement rate freeze
January 16, 2015
The Medicare Payment Advisory Commission has voted unanimously to make a series of recommendations to Congress that would either freeze reimbursements or make them site neutral. The goal is to potentially save Medicare several billion dollars. Also, in an effort to better incentivize primary-care doctors, MedPAC is asking Congress to restructure an initiative created by… more
Upton, DeGette Lay Out Basic Framework For 21st Century Cures Bill
January 13, 2015
House Energy & Commerce chair Fred Upton (R-MI) and Rep. Diana DeGette (D-CO) on Tuesday laid out five broad goals of the 21st Century Cures draft bill they plan to introduce later this month: targeting clinical trials to the “right group” of patients; better integrating the patient perspective into the regulatory process through public-private partnerships;… more
Medicare, Medicaid To Loom Large In 2015 On Capitol Hill & In Many States
January 6, 2015
Medicare and Medicaid reform issues are expected to loom large this year on Capitol Hill and in many states. Congress’ short-term Medicare physician payment patch ends after March and funding for the Children’s Health Insurance Program runs out Oct. 1. Legislation to avoid those pitfalls, especially physician payment cuts driven by the Sustainable Growth Rate… more
CardioBreak: PAD Approval, HF Drug for Duchenne
January 5, 2015
The FDA approved the IN.PACT Admiral drug-coated balloon for peripheral arterial diseasein the superficial femoral artery and popliteal artery, Medtronic announced. A technology using polymer beads to soak up inflammatory cytokines during heart-lung machine use for cardiac surgery has entered trials. The heart failure drug eplerenone (Inspra) slowed the progressive cardiac damage of Duchenne muscular… more
Interventional cardiology recognized as separate specialty by CMS
January 5, 2015
Effective on January 5, CMS now recognizes interventional cardiology as its own specialty. CMS in May had granted a request from the Society for Cardiovascular Angiography and Interventions for a new specialty designation for interventional cardiology; the new designation can now be used. The new specialty designation, C3, will enable interventional cardiologists to be compared against… more
AHA, ASA release annual statistical update for heart disease, stroke
January 4, 2015
The incidence of death due to heart disease and stroke has decreased in recent years, but the prevalence of both conditions remains high worldwide and risk factors such as tobacco use, an unhealthy diet and low levels of physical activity are common in adults and children. The annual Heart Disease and Stroke Statistics – 2015… more
CMS Adds 68,000 Records To Open Payments Database
December 22, 2014
CMS added about 68,000 payment records to the Sunshine Act and Affordable Care Act’s Open Payments database on Friday (Dec. 19). The Open Payments database details financial relationships among certain providers and drug and device manufacturers and group purchasing organizations.The additional records include updates to payments that were disputed by doctors and teaching hospitals at… more
Medicare Advisers Address Pay Disparities for Common Services
December 19, 2014
Congress’ advisers on Medicare will renew their call to change a system that now often pays hospitals more than private doctors’ office for delivering the same services. The Medicare Payment Advisory Commission on Thursday began discussing draft recommendations for many services covered by the federal health plan for the elderly and disabled. The panel will vote… more
Senate Sends to President Obama One-Year Tax Package With Medicare Cuts
December 17, 2014
Senators voted 76-16 late Dec. 16 to approve legislation that reduces some Medicare benefits to pay for a new type of tax-favored savings account. Included in a $41.6 billion tax extenders bill (H.R. 5771), which the White House says President Barack Obama will sign, is language from H.R. 647 to create tax-favored accounts for the… more
New Test Detects Heart Disease Risk, Especially for Black Women
December 15, 2014
A new test makes it easier for doctors to measure a fairly new indicator of heart disease risk — one that is especially helpful for African-American women. The U.S. Food and Drug Administration approved the test Monday. It measures the inflammation caused by the buildup of dangerous gunk in the arteries and can show a… more
ObamaCare’s Threat to Private Practice
December 10, 2014
Here’s a dirty little secret about recent attempts to fix ObamaCare. The “reforms,” approved by Senate and House leaders this summer and set to advance in the next Congress, adopt many of the Medicare payment reforms already in the Affordable Care Act. Both favor the consolidation of previously independent doctors into salaried roles inside larger institutions,… more
‘Doc Fix’ Uncertainty Freezes Other Health Efforts, Panel Is Told
December 10, 2014
Failure to replace Medicare’s oft-criticized physician payment formula has shifted federal attention away from other necessary health reforms, witnesses told a House hearing on Tuesday, further stoking the debate over advancing permanent “doc fix” legislation in Congress. “The sustainable growth rate was designed to control Medicare physician reimbursements, but has instead continued to stifle other federal… more
A Focus on the Heart for Older Patients
December 4, 2014
The first geriatric cardiology clinic in New York opened at N.Y.U. Langone Medical Center in August. It’s different. For starters, an older patient’s first visit with cardiologist Dr. John A. Dodson, the program’s director, takes a full hour. Beyond taking a complete history, Dr. Dodson looks for frailty by measuring things like gait and grip… more
Leader of Republican Doctors Caucus Sees No Action on SGR During Lame Duck
December 4, 2014
Efforts to find a long-term fix for Medicare’s sustainable growth rate (SGR) formula for physician payment will have to wait until 2015, the co-chairman of the Republican Doctors Caucus said Dec. 4. Speaking to reporters, Rep. Phil Roe (R-Tenn.) said he plans to take up the issue in the early days of the 114th Congress…. more
Medicare Contributes To Slow National Health Care Spending Growth In 2013
December 3, 2014
Health care spending increased 3.6 percent in 2013, which one CMS official says is the lowest percentage on record going back to 1960, driven by slow growth rates in private insurance and Medicare. Some Affordable Care Act provisions — including the medical loss ratio provisions, Medicare productivity adjustments, and cuts to Medicare Advantage — put… more
House Passes Bill on Savings Accounts For Disabled, Funded by Medicare Changes
December 3, 2014
A bill that would make tax-free savings accounts available to people with disabilities passed the House by a 404-17 vote Dec. 3. Twelve Democrats and five Republicans voted against the bill. Although the Achieving a Better Life Experience (ABLE) Act (H.R. 647) enjoyed bipartisan support, lawmakers said they were concerned about the bill’s use of… more
CMS Proposes Revising How Accountable Care Organizations Are Paid
December 1, 2014
Health provider alliances known as accountable care organizations could be paid differently under a proposed rule released by the Centers for Medicare and Medicaid Services late Monday. If hospitals and doctors that coordinate the care of Medicare patients save money, they can share some of the savings with the government. The proposed rule affects the… more
Rest of lame duck won’t be a snooze
November 30, 2014
December was supposed to be a sleepy month for Congress — a chance to finish up a productive lame-duck session and leave the decks clear for the new Republican majority that takes control in January. Instead, the next two weeks have morphed into a minefield. Government funding is suddenly in peril, as conservatives fume over… more
CMS Guide Foresees Increased Use Of CED, Even In Local Coverage Calls
November 25, 2014
CMS signals plans to increasingly rely on coverage with evidence development (CED) in a final guidance that backs away from an earlier expectation that the agency would only use the policy infrequently as new technologies were presented for coverage early in the development process. The agency also reiterates that it will neither duplicate efforts by… more
As Doctors Push For Unpaid SGR Bill, Budget Think Tank Suggests Offsets
November 19, 2014
As physicians lobby Congress to replace the Sustainable Growth Rate without paying for the fix, the think tank Center for a Responsible Federal Budget published Wednesday (Nov. 19) a plan to pay for Medicare physician-pay reform using policies that generate half of the savings from providers and half from beneficiaries — beneficiary policy changes would… more
Providers, Consumers Urge NAIC To Address Concerns On Network Adequacy
November 19, 2014
The American Medical Association has joined forces with more than 115 health care groups to urge the National Association of Insurance Commissioners (NAIC) to address several key issues as it puts together a final model regulation on network adequacy that will affect exchange and other insurance plans. The AMA, Children’s Hospitals Association and other national and state-level… more
Wyden Urges Quick Action on ‘Doc Fix,’ Citing Rising Costs
November 19, 2014
Senate Finance Chairman Ron Wyden said the rising cost of replacing Medicare’s physician payment formula adds urgency to the effort to pass compromise legislation during the lame duck instead of waiting until the March 31 deadline to prevent scheduled cuts to doctors. The Congressional Budget Office estimated late Friday that a bipartisan, bicameral “doc fix” plan introduced in… more
CBO’s Estimated Cost Of Freezing Medicare Physician Pay Falls Slightly
November 17, 2014
The Congressional Budget Office lowered by $5 billion its 10-year estimate of the cost of freezing Medicare payments to physicians, which is good news for those pushing to replace the Sustainable Growth Rate formula. However, physicians are lobbying to replace SGR without paying for it, and some Republicans reportedly are warming to the idea. When… more
SCOTUS subsidies case weighs on states
November 17, 2014
Insurance regulators in states where HHS runs the Obamacare exchanges are discussing contingency plans or workarounds should the Supreme Court strip the law’s insurance subsidies across a wide swath of the country. The discussion of the King v. Burwell case came up on Monday at a meeting of the National Association of Insurance Commissioners in… more
SGR, CHIP fixes potentially on lame-duck agenda, but prospects look slim
November 12, 2014
The only major task likely to get done during the four-week lame-duck session that Congress started Wednesday will be to provide continuing funding for the federal government, which is slated to run out of money Dec. 11. That funding effort will include debate over the Obama administration’s request for $6.2 billion in funding to fight… more
AMA Presses for Permanent SGR Fix During Congress’s Lame-Duck Session
November 12, 2014
The American Medical Association is pressing Congress to pass a permanent fix for how Medicare reimburses physicians during the lame-duck session that begins this week. AMA President Robert Wah in a Nov. 10 blog post said the lame duck session “is a perfect opportunity to end the broken cycle of temporary patches” to the sustainable… more
Despite prevalence of PAD symptoms, the majority of patients have not consulted a physician
September 30, 2014
More than 40 percent of Americans aged 40 and older have experienced one or more of the most common symptomsi of peripheral arterial disease (PAD). However, the majority are unfamiliar with the disease and relatively few who experience symptoms see a doctor, according a recent online awareness survey conducted by Harris Poll.ii The Covidien-sponsored survey… more
Podiatry Today: PAD Awareness Month And The Case For Limb Preservation
September 1, 2014
Unlike October, which is abundant with the color pink and matching ribbons symbolizing Breast Cancer Awareness Month wherever we turn, we have no such ribbon for Peripheral Artery Disease (PAD) Awareness Month. In my travels over the past few years, I have noted several instances that illustrate a lack of PAD awareness and understanding among… more
Low Income and Lower Education Levels Associated with Peripheral Vascular Disease in U.S. Adults
August 19, 2014
Recent findings published by the American Heart Association reveal that U.S. adults with lower socioeconomic status are at higher risk for developing Peripheral Vascular Disease (PVD) – highlighting the need for education and advocacy among at-risk populations. According to the study published in Circulation: Cardiovascular Quality and Outcomes, individuals with low income and lower education… more
JAMA Surgery: Aortic Stents Safer for Aneurysm Repairs
August 19, 2014
Post-operative complications and mortality rates were significantly lower for patients with abdominal aortic aneurysms repaired via endovascular stent grafts, according to new research published in the Journal of the American Medical Association (JAMA). Although anecdotal evidence and randomized clinical trials have long supported that endovascular repair is safer than more invasive, open surgeries, the published… more
Dark Chocolate Improves Walking Autonomy in Patients With Peripheral Artery Disease
August 19, 2014
Patients with Peripheral Artery Disease (PAD) might find relief from dark chocolate, according to research published in the Journal of the American Heart Association. PAD – a common circulatory problem where narrowed arteries reduce blood flow to the limbs – often results in pain when blood flow cannot keep up with the body’s demands, particularly… more
Extended Release Niacin-Laropiprant Proves More Harmful than Helpful in High-Risk Patients
August 19, 2014
Patients receiving statin therapy for high cholesterol who additionally received a combination of extended-release niacin and laropiprant, saw reductions in their HDL, but saw no difference in the rate of major vascular events. The test group, in fact, experienced a higher rate of adverse events and complications when compared to patients taking a placebo. The… more
Scientists Discover Genetic Switch that Can Prevent Peripheral Vascular Disease in Mice
August 19, 2014
Scientists at the University of Texas Health Science Center at Houston have tested a non-surgical treatment in mice that could improve Peripheral Vascular Disease (PVD) by increasing blood circulation in the extremities. Researchers were able to identify a genetic “switch” that suppresses blood vessel development, and then turn off that switch in mice – allowing… more
Endovascular Today: The Outpatient Endovascular and Interventional Society
January 1, 2014
Although outpatient or office-based interventional suites have been operational for many years, there has been a marked proliferation of these sites in multiple states in the past 3 years. It is estimated that nearly 350 to 400 office-based labs exist in the United States to date, and that number is growing rapidly. Office-based labs, also… more
Preventive Aspects in Peripheral Artery Disease
June 2, 2012
Abstract The prevalence of peripheral artery disease is steadily increasing and is associated with significant morbidity, including a significant percentage of amputations. Peripheral artery disease often goes undiagnosed, making its prevention increasingly important. Patients with peripheral arterial disease are at increased risk of adverse cardiovascular outcomes which makes prevention even more important. Several risk factors… more