Revenue & Reimbursement

Healthcare reimbursement is payment that a hospital, diagnostic imaging facility, subspecialty department or healthcare providers receive for performing a service. This also includes individual radiologist or cardiologist reimbursement and billing and coding rules for submitting claims.

AMA analysis of Medicare Trustee data shows Medicare updates compared to inflation 2001-2021.

More than 120 medical societies have joined the AMA in a letter urging congressional leaders to enact long-term solutions to the systemic problems in the Medicare physician payment system and to address cuts that are going into effect in 2023.

Medicare money payment physician

Dozens of medical societies have signed a new letter urging Congress to stop upcoming Medicare payment cuts. “The Medicare payment system remains on an unsustainable path threatening beneficiaries’ access to physicians," they wrote. 

medical billing_5.jpg

The American College of Cardiology has developed a helpful calculator that allows cardiologists and practice managers to estimate just how much the proposed 2023 MPFS could impact their practice.

How to get paid, reimbursed, for cardiac CT, CTA CCTA. #SCCT #SCCT2022

Ahmad M. Slim, MD, associate professor of medicine with the University of Washington and regional chief medical officer with the Pulse Heart Institute, explained how imagers get paid for coronary computed tomography angiography (CCTA) exams.

Doctor patient

CMS also announced that the penalty phase of its Appropriate Use Criteria Program has been delayed yet again.

American Society of Echocardiography (ASE) past president Jonathan Lindner, MD, FASE, is a newly named advisor to the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC), which advises the Centers for Medicare and Medicaid Services (CMS) on whether services and supplies are reasonable and necessary under Medicare.

As a MEDCAC advisor, American Society of Echocardiography past president Jonathan Lindner, MD, will help decide whether services and supplies are reasonable and necessary under Medicare.

Doctor patient

The additional costs associated with AFib ablation appear to be justified, researchers wrote.

The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

American Society of Nuclear Cardiology (ASNC) delegates to the American Medical Association (AMA) House of Delegates 2022 meeting Stephen Bloom, MD, and Nishant Shah, MD, explain a new AMA policy asking Congress to revise its clinician decision support mandate. 

He was charged with three counts of healthcare fraud for an alleged scheme involving office visits that never occurred.

The long legal saga of Richard Paulus, a Kentucky cardiologist accused of performing unnecessary cardiac procedures, appears to still be going strong in 2022 and might be reviewed by the Supreme Court.

Kentucky cardiologist Richard Paulus was first found guilty back in October 2016, but he was granted a new trial in 2021. 

The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

Over the past few weeks, members of ASNC’s Health Policy Committee have held meetings with their members of Congress.

The U.S. Congress is working on healthcare legislation to fix medicare reimbursements and end annual cuts to physicians.

Multiple cardiology societies, including the ACC, ASE and SCAI, want to work with Congress to update Medicare payment policies. 

Around the web

Validation and testing of all algorithms is needed to eliminate any biases in the data used to train the AI, according to Julius Bogdan, vice president and general manager of the HIMSS Digital Health Advisory Team for North America.

More than 120 medical societies have joined the AMA in a letter urging congressional leaders to enact long-term solutions to the systemic problems in the Medicare physician payment system and to address cuts that are going into effect in 2023.

Three medical journals are investigating possible manipulation of data in heart studies led by researchers from Temple University that found favorable health impacts of blood thinners.

   
   
   
   
   
Trimed Popup
Trimed Popup