Senate passes bill to permanently end SGR Formula

Healthcare providers can breathe a sigh of relief as the Senate passed the H.R. 2 bill late last Tuesday night before the Centers for Medicare and Medicaid Services planned to reduce physician reimbursement by 21.2 percent, as mandated by SGR. President Obama has said he will sign the bill. However, due to timing, it is expected that a “small volume of claims” will be subject to the April 1 cuts.  CMS has said that those claims will be reprocessed automatically so that the providers will be made whole and further cuts will be averted.

Your ASE volunteer Advocacy Committee, chaired by David Wiener, MD, FASE, along with ASE’s VP of Health Policy, Irene Butler, our legislative advisor Diane Millman, and lobbyist Peggy Tighe worked tirelessly behind the scenes to bring this bill to Congress without the inclusion of site neutrality language.  This was ASE’s key issue this year– to assure protection of our patients ability to access quality cardiovascular care, especially in rural areas often served by one hospital. Your grassroots efforts combined with the ASE advocacy efforts ensured that patient access to echocardiography was preserved in this bill.

You can be confident that ASE continues to work on your behalf with a strong and well organized coalition on this and other issues, such as the opposing the elimination of the in-office ancillary exception.  ASE is the leading voice on the Hill for echo-related issues and your membership is key to making this monitoring and activity happen.

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ASE Worked to Establish a New Code for Echocardiography

While the U.S. Congress and CMS continues to cut many areas of healthcare, ASE is proud to announce that our CPT team succeeded in the acceptance of a new myocardial strain imaging code. ASE was able to present compelling data to establish a Category III code, 039X9T, for imaging of myocardial strain for the detection of myocardial deformation. While Category III codes generally are not reimbursed, they often lead to the adoption of payable codes. This victory is a one step closer to ensuring patients have access to critical care and that our members are appropriately compensated for their important work. We will follow this code closely as it makes its way to CMS and commercial payers.

Please note this code is expected to go into effect on January 1, 2016.

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Proposed Rule seeks to ensure continued viability of Medicare ACO Program

CMS recently made available a Proposed Rule setting forth a number of changes to the Shared Savings Program (SSP) for Accountable Care Organizations (ACOs).  ASE has developed a summary of the major changes in the Proposed Rule and addressed some interesting information about ACO performance thus far.

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CMS Release PFS and OPPS final Rule, with a New Interventional Transesophageal Echocardiography code beginning in 2015

On Friday, October 31, the Centers of Medicaid and Medicare released the PFS and OPPS final rules. We are proud to announce that after a year and half of work, CMS has approved and provided a value for a new interventional transesophageal echocardiography code beginning in 2015! Read more here.

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New Quality Requirements for Echo Under Medicare

Please note that, effective January 15, 2015, new quality requirements will be applicable to echo providers in a number of states, including Illinois (for Part B providers), Maine, Massachusetts, Minnesota, New Hampshire, Rhode Island, Vermont and Wisconsin. Learn more here.

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Meet ASE’s Advocacy Team

You’re invited to a brief meet-up with your fellow ASE members, our President, Dr. Neil Weissman; our CEO, Robin Wiegerink; advocacy staff, and our lobbyist Peggy Tighe on Monday, September 15 for conversation and networking. If participating in the ACC’s Legislative Conference, TCT, joining ASEF’s Value-Based Healthcare Summit, or working in the area, don’t miss the opportunity to join us. ASE is your voice in the Hill; your participation will strengthen our efforts to advocate for cardiology-related causes and push for appropriate patient care and reimbursement policies. We invite you to join us from 6:00 pm – 7:15 pm at the Westin hotel’s Caucus Room Brasserie-Steakhousebar. The hotel is in Georgetown at 2350 M Street NW, down the street from the ACC’s conference location. If you have questions, feel free to contact Irene Butler at ibutler@asecho.org.

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Summary of the PFS and HOPPS Proposed Rules

On July 3, 2014, CMS made available on the internet the proposed 2015 Medicare payment rates and policy changes under the PFS and HOPPS. ASE has developed a summary with provisions of the proposed rates and policies of interest to the society and its members. Charts summarizing the proposed changes in Medicare rates are included to help clarify these proposed rates.

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SGR Repeal Legislation Introduced

The “SGR Repeal and Medicare Provider Payment Modernization Act of 2014” bill was introduced in the House on February 6. This proposed language was agreed to by the Energy & Commerce, Ways & Means, and Senate Finance committees to repeal the SGR. The bill includes policy provisions; however the policy extenders and financial offsets are still to be negotiations.

A copy of the bill, a summary of the bill and an official section-by-section summary of the legislation can be found here.

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