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.

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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.

Cardiologist Jonathan Lindner to advise influential Medicare committee

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.

July 6, 2022
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AFib ablation makes financial sense, especially among heart failure patients

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

July 1, 2022
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 They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems.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.

VIDEO: AMA will ask Congress to revise clinical decision support mandate for cardiac imaging

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. 

June 22, 2022

New York cardiologist charged for alleged involvement in COVID-related fraud scheme

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

April 22, 2022
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. The New York state radiologist is facing 36 misdemeanor counts for secret sexual recording without consent, according to a story in the Boston Herald.

Cardiologist’s legal fight against fraud conviction may be heard by Supreme Court

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

April 20, 2022
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 urges Congress to speed prior authorizations, repeal AUC mandate 

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

April 18, 2022
The U.S. Congress is working on healthcare legislation to fix medicare reimbursements and end annual cuts to physicians.

Cardiology societies want to help Congress reform Medicare

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

February 28, 2022
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American Heart Association supports new ‘surprise billing’ legislation, but physician groups have serious doubts

According to the AHA, the No Surprises Act will "make a truly meaningful difference" to millions of patients. Physicians, on the other hand, have shared significant concerns about the legislation. 

December 7, 2021
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Around the web

Health Imaging
New imaging protocols proposed to curb rise of cardiovascular infections

Eleven medical societies have signed on to a consensus statement aimed at standardizing imaging for suspected cardiovascular infections.

Radiology Business
What does radiology have to do with climate change?

Kate Hanneman, MD, explains why many vendors and hospitals want to lower radiology's impact on the environment. "Taking steps to reduce the carbon footprint in healthcare isn’t just an opportunity," she said. "It’s also a responsibility."

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