Cardiac Insight Comments on Medicare Administrative Contractor Novitas Rate Publication
Cardiac Insight, Inc. a healthcare innovator specializing in wearable cardiac sensors and proven automated electrocardiogram (ECG) analysis that delivers highly differentiated benefits to healthcare providers and patients, commented on the recent reimbursement rates published by Medicare Administrative Contractor (MAC) Novitas Solutions (Novitas) for CPT codes 93241, 93243, 93245, and 93247.
These include the global and technical components for the newly established Category I codes for long-term electrocardiogram (ECG) monitoring, effective January 1, 2021. Novitas provides administrative and claims processing services for state and federal health care programs such as Medicare and Medicaid and is owned by GuideWell.
"We are astonished and disappointed by the direction CMS and Novitas have taken, specifically Novitas, with its announcement of a 74% average reduction in physician procedure global reimbursement compared to prior Category III tracking CPT code rates. This untenable decision significantly sets back patient care as it will limit access to extended ECG testing for patients and physicians nationwide," said Brad Harlow, CEO of Cardiac Insight. "We have seen firsthand the positive impact prescription, medical grade ECG wearables make to improve the detection, diagnosis and treatment of life-threatening cardiac arrhythmias in patients at risk, especially for those suffering from atrial fibrillation. These extremely low reimbursement rates will have negative repercussions for health outcomes, especially for the increased risk of stroke and heart failure. Providers and patients, particularly seniors, should be outraged by this decision. We plan to seek additional information from GuideWell and Novitas."
Cardiac Insight provides the only all-inclusive seven-day ambulatory ECG system, the Cardea SOLO™, that includes in-office rapid automated ECG analysis and reorting to detect arrhythmias, including atrial fibrillation. Cardea SOLO™ speeds the time to diagnosis and simplifies the diagnostic process by enabling clinicians to generate an automated report immediately in-house without the need to outsource to third parties. Long-term continuous ECG monitors like Cardea SOLO™ and those provided by other companies, such as iRhythm Technologies, Inc. and Preventice Solutions, have been shown to provide clinical benefits over traditional Holter monitors, as extended ECG recorder wear times can increase diagnostic yield by over 25%.
"By setting low physician procedure reimbursement on a relatively low-cost, high yield cardiac diagnostic test, CMS and Novitas are ignoring scientific evidence and the professional judgement of thousands of physicians and heart specialists who prescribe ECG wearables because they provide the best and most convenient care for their patients," said Robert G. Hauser, MD, FACC, FHRS, former President of the Heart Rhythm Society and Emeritus Senior Consulting Cardiologist, Minneapolis Heart Institute. "The Heart Rhythm Society, American College of Cardiology, American Heart Association, and all patient advocacy groups should object to this ruling by Novitas and the approach taken by the Centers for Medicare and Medicaid Services. Their actions are not in the best interest of patients and certainly do not put patient health first."
ABOUT CARDIAC INSIGHT, INC: Cardiac Insight, Inc. (www.cardiacinsightinc.com) is a leading U.S. digital healthcare innovation company specializing in the development of medical-grade, body-worn ECG sensor technology and automated cardiac analysis solutions through its proprietary algorithms and software platforms. The company's products include the Cardea SOLO™ wearable ECG Sensor and Software Analysis System as well as the Cardea 20/20 ECG™ - the only resting ECG System designed for cardiac risk screening in active youth and athletes at all levels of play. AFib is the most common type of treated heart arrhythmia, with an estimated 2.7 to 6.1 million people in the U.S. living with this arrhythmia. While AFib itself is typically not life-threatening, complications from AFib if left untreated include increased risk for heart problems and heart failure, and increased risk for stroke. AFib is responsible for about one in seven strokes.
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