• December 6, 2013

    In This Issue:





    2014 Medicare Fee Schedule Reflects SCAI Recommendations

    The results of SCAI advocacy were apparent in the 2014 final payment regulations published last week by the Centers for Medicare and Medicaid Services (CMS). Since the proposed rule was issued in July, the Society’s Advocacy team has worked to secure fair reimbursement for invasive/interventional cardiovascular services. The outcome of this focused advocacy appears across the Medicare Fee Schedule, including in the avoidance of a fee cut that saved the field at least $60 million. For more information, read on …

    In-Office Procedures

    Among several indications that the Medicare agency has been listening to SCAI was its decision to back off a proposal to cap payments for in-office procedures at no more than the Medicare rates for similar procedures in hospital outpatient departments (HOPDs) or ambulatory surgical centers (ASCs). SCAI and other groups fought this proposal, earning the backing of the American Medical Association, by demonstrating that the CMS was making comparisons that were neither fair nor complete. Had CMs proceeded as originally proposed, payments for some in-office peripheral procedures would have been cut by up to 40 percent, costing interventional cardiologists more than $60 million.

    SCAI expects that CMS will continue to scrutinize the costs associated with these procedures, one of several reasons that physicians and coding staff must take steps to ensure they are accurately documenting the cost of providing these services. If you or your facility peforms these procedures outside of hospitals, please contact Dawn Hopkins at dhopkins@scai.org. You can be instrumental in future advocacy on this issue.   

    Coverage of Clinical Trials Procedures

    CMS also modified its proposal to centralize and restrict its coverage of procedures performed as part of clinical trials. SCAI argued that non-inferiority trials offering patients more options facilitating competition can hold down healthcare costs. In 2014, CMS will proceed with plans to centralize decision making but it will not require all studies to be superiority trials.

    The Bottom Line

    The net impact of the Final Rule on cardiologists is that average relative value units (RVUs) will rise about 1 percent.  SCAI’s advocacy team notes that actual 2014 fees remain difficult to predict, given the current uncertainty around whether Congress will take action on the sustainable growth rate (SGR).  The House of Representatives is scheduled to take up this issue on Dec. 12, 2013; however, the likelihood that the issue will be resolved before the holidays is slim. If the SGR isn’t repealed, revised or “patched,” across-the-board fee cuts of 25 percent will be enacted on Jan. 1, 2014. Based on how the SGR has been handled in prior years and the current gridlock in Washington, DC, SCAI experts expect no action to be taken this year and that retroactive legislation will pass in 2014.

    To stay current on this and other issues affecting the practice of invasive/interventional cardiology, visit www.SCAI.org/Advocacy.

    Read the Comment Letter

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    SCAI Offers Guidance on Transcatheter Therapies for Mitral Regurgitation

    In a key overview document released last week, four cardiovascular societies — SCAI, American College of Cardiology, American Association for Thoracic Surgery, and Society of Thoracic Surgeons — examined the responsible dissemination of transcatheter therapies for mitral regurgitation. Developed to “help frame subsequent discussions” among the field’s various stakeholders, the document highlights critical issues that should be considered as the technologies are integrated into clinical practice, including operator training, protocols for care, and assessment of outcomes.

    SCAI Past President Carl Tommaso, MD, FSCAI, represented the Society on the writing committee. “This document is timely considering the FDA’s recent approval of MitraClip for patients with severe, degenerative mitral regurgitation who are considered by a Heart Team to be ineligible for surgery,” he said. “In addition, other technologies, including annuloplasty devices and neochordal implants, with the potential to reduce mitral regurgitation are in the pipeline. This guidance document will help us anticipate some of the important issues the field is likely to face in ensuring that the right patients receive optimal care with these therapies.”

    Transcatheter Therapies for Mitral Regurgitation Societal Overview was e-published in SCAI’s journal, Catheterization and Cardiovascular Interventions, as well as the journals of the partner societies.  

    Read the Press Release

    Download the Document

    Read the Media Coverage:

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    SCAI Requests CMS Take Immediate Action on Medicare Advantage

    SCAI has joined over 80 state and national medical associations in urging the Centers for Medicare & Medicaid Services (CMS) to take immediate action to ensure that Medicare beneficiaries participating in Medicare Advantage (MA) plans have accurate and reliable information to make health insurance elections during the 2014 Open Enrollment period, and to address a lack of MA sponsor transparency on network adequacy. 

    SCAI has been contacted by a number of physicians indicating that they have been terminated from 2014 MA plan networks of UnitedHealthcare (United) and other insurers in select markets.  SCAI is greatly concerned because the terminations are “without cause” and have been timed in a manner that undermines the accuracy and reliability of the information Medicare beneficiaries are relying upon in order to make important health care decisions for 2014 health insurance coverage.  The timing and process used to communicate the terminations and modifications to the networks are not consistent with CMS guidance and regulations. 

    Read the Comment Letter

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    SCAI 2014: Call for Your Great Coronary, Structural & Peripheral Cases!

    Want to get more involved in SCAI 2014? Here's your chance!

    Back by popular demand after its introduction last year, the Intervention, Interaction and Input (i3) Session will feature a series of coronary, structural, or endovascular (including arterial and venous) cases, an open-mike forum for discussion, and critical input from expert faculty.

    So what are you waiting for? Show your great cases: therapeutic dilemmas, disasters, saves, close-calls, creative approaches, YOU NAME IT.

    Find Out More Including Submission Instructions

    Register Now for SCAI 2014 in Las Vegas

    Reminder: SCAI 2014 Abstract Submissions Due December 18!

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    Miss SCAI/ACC Webinar on Coding Changes? Access Webinar Archive

    SCAI, ACC hosted a joint webinar on Wednesday afternoon, preparing attendees for changes coming to cardiology coding in 2013.

    Featuring presentations by leading CPT experts Robert Piana, MD, FACC and Art Lee, MD, FSCAI and clinical expert Srihari Naidu, MD, FSCAI, this two-hour webinar walked attendees through real-world examples of how these new codes should be used, revisited the new PCI code family that went into effect in 2013.and featured plenty of opportunities for questions and ensuing discussion.

    Access the Webinar Archive Now!

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    CCI: New Early View Content in Pediatric & Congenital Heart Disease

    In order to get critical information to members as soon as possible, SCAI's official journal, Catheterization & Cardiovascular Interventions (CCI), offers accepted manuscripts online in its Early View Section prior to inclusion of that manuscript in a print issue.

    The following Early View original studies and case reports in Pediatric and Congenital Heart Disease have been made available online since November 1 - just log in at www.SCAI.org:

    Pediatric and Congenital Heart Disease

    Original Studies


    A prospective observational multicenter study of balloon angioplasty for the treatment of native and recurrent coarctation of the aorta
    Kevin C. Harris, Wei Du, Collin G. Cowley, Thomas J. Forbes and Dennis W. Kim, On Behalf of the Congenital Cardiac Intervention Study Consortium (CCISC)
    Article first published online: 4 DEC 2013 | DOI: 10.1002/ccd.25284
    ABSTRACT | Members CLICK HERE to Access Full Issue

    Interventional Rounds


    Endovascular stent provides more effective early relief of SVC obstruction compared to balloon angioplasty
    Osamah Aldoss, Nofil Arain, Jeremiah Menk, Lazaros Kochilas and Daniel Gruenstein
    Article first published online: 4 DEC 2013 | DOI: 10.1002/ccd.24413
    ABSTRACT | Members CLICK HERE to Access Full Issue

    Original Studies


    Palliative stenting of patent ductus arteriosus in older children and young adults With congenital cyanotic heart disease
    Edwin Francis, Shine Kumar and Raman Krishna Kumar
    Article first published online: 30 NOV 2013 | DOI: 10.1002/ccd.24373
    ABSTRACT | Members CLICK HERE to Access Full Issue

    Case Reports


    Complete blalock–taussig shunt obstruction in < 24 hours post-operative period in a neonate treated emergently using transcatheter angioplasty and low dose local recombinant TPA
    Amit Patange, Jennifer Blake and Srinath Gowda
    Article first published online: 21 NOV 2013 | DOI: 10.1002/ccd.25281
    ABSTRACT | Members CLICK HERE to Access Full Issue


    Percutaneous device closure of abernethy malformation—A treatable cause of hepatopulmonary syndrome
    Subramanian Venkateshwaran, Kavassery Mahadevan Krishnamoorthy and Sivasubramonian Sivasankaran
    Article first published online: 19 NOV 2013 | DOI: 10.1002/ccd.25275
    ABSTRACT | Members CLICK HERE to Access Full Issue

    Original Studies


    Treatment of congenital non-ductal shunt lesions with the amplatzer duct occluder II
    I.B. Vijayalakshmi, Chitra Narasimhan, Bhupinder Singh and C.N. Manjunath
    Article first published online: 18 NOV 2013 | DOI: 10.1002/ccd.25250
    ABSTRACT | Members CLICK HERE to Access Full Issue

    Case Report


    Failing left ventricle to ascending aorta conduit—Hybrid implantation of a melody valve and NuMed covered stent
    Mario Gössl, Jonathan N. Johnson and Donald J. Hagler
    Article first published online: 18 NOV 2013 | DOI: 10.1002/ccd.25075
    ABSTRACT | Members CLICK HERE to Access Full Issue


    Intervening for RPA stenosis following Waterston shunt: Importance of anatomical definition of the coronary arteries
    Ian W. Hovis, Nicole J. Sutton and Robert H. Pass
    Article first published online: 18 NOV 2013 | DOI: 10.1002/ccd.25003
    ABSTRACT | Members CLICK HERE to Access Full Issue

    Original Studies


    Ductal spasm during performance of transcatheter ductal occlusion
    Sarosh P. Batlivala, Andrew C. Glatz, Matthew J. Gillespie, Yoav Dori and Jonathan J. Rome
    Article first published online: 9 NOV 2013 | DOI: 10.1002/ccd.25120
    ABSTRACT | Members CLICK HERE to Access Full Issue


    Transvascular closure of single and multiple muscular ventricular septal defects in neonates and infants < 20 kg
    P. Zartner, C. Christians, J.C. Stelter, V. Hraška and M.B.E. Schneider
    Article first published online: 9 NOV 2013 | DOI: 10.1002/ccd.25177
    ABSTRACT | Members CLICK HERE to Access Full Issue

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    Mended Little Hearts to Host Free Webinar on Rhythm Issues in Children

    Mended Little Hearts will host a free webinar on Common Rhythm Issues in Children on Monday, December 9, 5-6 PM ET.

    This webinar may be a useful resource to share with your patients. The primary rhythm issues to be discussed will include SVT (supraventricular tachycardia) and WPW (Wolff-Parkinson White Syndrome). The webinar will also include information on heart rhythms, such as complete heart block (CHB) and ventricular tachycardia.

    Additional Information, Including Registration

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