The federal Department of Justice (DOJ) recently announced a novel approach to accelerate its ongoing investigation of implanted cardioverter defibrillator (ICD) procedures performed outside of CMS’s National Coverage Decision (NCD).
DOJ seeks to accelerate ICD implant investigation
In breaking news this week, the Centers for Medicare and Medicaid Services (CMS) announced its final national coverage decision policy for transcatheter aortic valve replacement (TAVR) as an alternative to open aortic valve replacement (AVR) for clinically indicated patients. While considered a boon to the future of the innovative procedure, CMS has set strict hospital and operator requirements to qualify as a TAVR-performing site and receive reimbursement. Therefore, the final coverage decision will serve to effectively limit TAVR adoption to the most qualified programs and place the procedure in the hands of the most skilled operators – a policy widely accepted by regulators and professional societies alike.
CMS finalizes coverage for TAVR
On Tuesday CMS issued its inpatient prospective payment system (IPPS) proposed rule for fiscal year (FY) 2013, which would increase Medicare operating payments to acute-care hospitals by 0.9% after accounting for various policies in the proposed rule and projected utilization of inpatient services.
Under the proposed rule, general acute care hospitals participating in the Hospital Inpatient Quality Reporting program will see payment rates increase by 2.3% which accounts for inflation, productivity improvements, a statutory adjustment factor, and adjustments for documentation and coding changes. Those that do not participate would receive a 2.0% reduction, or an overall payment rate update of 0.3%.
The proposed rule affects about 3,400 acute care facilities and it is expected to increase acute care hospital payments by $175 million in FY 2013 compared to FY 2012.
Impact of 2013 IPPS proposed rule on CV services