Friday, September 16, 2022

Is Eecp Covered By Medicare

Don't Miss

When Eecp Is Recommended

Vasomedical EECP Inside Business

Based on what we know so far, EECP therapy should be considered in anybody who still has angina despite maximal medical therapy, and in whom stents or are deemed not to be good options.

Medicare has approved coverage for EECP for patients with angina who have exhausted all their other choices.

In 2014, several professional organizations finally agreed in a focused update that EECP treatment ought to be considered for patients with angina that’s not helped by other treatments. These organizations are:

  • The American College of Cardiology
  • American Heart Association

Is Eecp Flow Therapy Right For You

Are you experiencing symptoms like chest pain, shortness of breath, or fatigue? Have you been diagnosed with angina, coronary heart disease, heart failure, or heart attack?

Take a 1-minute self-evaluation to see if EECP Flow Therapy is right for you. Together, well set you on a path back to health and happiness.

I was not familiar with EECP and was uncertain when I began the program. I had tried several options to resolve my chest discomfort and it still persisted. Now after completing the treatments, I can tell you that I feel so much better. I now can run up and down the stairs with little difficulty breathing or chest pain.

Mr. Matthews, 66

Shortness of breath, I think, affected me more than anything, even when I walked my dog. Id have to take a rest about halfway through the walk to catch my breath. Now I dont have that problem. No angina either.

Mr. Berger, 45

I came to Flow Therapy as a result of my cardiologist ascertaining that I have small vessel heart disease for which any kind of surgery is not an option. After treatment, I swam 26 laps in my pool. Now its only 40 feet long, but thats 26 laps further than I could do when I started this program!

Ms. Valerie, 54

Cardiologist Pleads Guilty To An Astounding $19 Million Medicare Fraud Scheme

Dr. Jose Katz, co-founder and CEO of Cardio-Med Services LLC and Comprehensive Healthcare & Medical Services, operated a cardiology and internal medicine empire. Katz had clinics in Union City, Paterson, West New York, Manhattan and Queens according to official court documents.

In addition to the $19 million Medicare fraud, Katz spent an amazing $6 million on an all-Spanish radio and TV advertising campaign in an effort to usher more patients into his Cardio-Med and Comprehensive Healthcare offices. Unfortunately for Katz, his direct marketing campaign to the Spanish community backfired, creating more business than he could effectively manage. Once the ads began running, they reportedly, attracted hundreds of patients to the Katz companies every day, according to court documents.

You May Like: What Is Monthly Premium For Medicare

Eecp May Be Right For You If

  • You have heart failure or angina that medication no longer relieves.
  • You have returning symptoms after open-heart surgery, angioplasty, or other invasive procedures and you have been told another procedure is not an option.
  • Your doctor will need to review your medical history and examine you to decide if EECP is an option to help relieve your symptoms.

Is There A Doctor In The House

EECP

With the Spanish ad campaign bringing in so many new patients, Katz was forced to take on some additional help for his practice. He hired Mario Roncal, a graduate of Puerto Ricos San Juan Bautista School of Medicine. While hiring another doctor may seem like a good idea, the problem was that Roncal is not a licensed physician in New Jersey or New York, as the San Juan Bautista School of Medicine is not an accredited medical institution.

Roncal was a willing participant in Katzs Medicare fraud scheme, pretending to be a legitimate physician at each of the Katz clinics. He allegedly went so far as to forge Dr. Katzs signature on hundreds of patient records and insurance forms, in addition to ordering medically unnecessary tests and procedures. For his participation in the fraudulent activity, Roncal pleaded guilty to Conspiracy to Bill Medicare for Unlicensed Physicians Services earlier this year.

You May Like: How Is Part B Medicare Premium Determined

The Medicare Fraud Details

Dr. Katz allegedly took advantage of his new Spanish clientele by falsely diagnosing most of his Medicare and Medicaid patients with coronary artery disease or debilitating angina. Once given a phony medical diagnosis, Katz then ordered thousands of unnecessary blood tests and compression treatments for his patients.

The reason for Katz purposely misdiagnosing his patients with coronary artery disease or debilitating and inoperable angina? Patients who receive this type of diagnosis can be treated with expensive enhanced external counterpulsation therapy. EECP therapy is a costly procedure that is Medicare approved for treating patients with disabling stable angina that was inoperable or for which surgery would be highly risky. One EECP treatment usually takes about an hour to complete and an entire course of EECP therapy typically requires the patient to receive no less than 35 treatments.

When performed on those who are properly diagnosed, EECP therapy can decrease symptoms of inadequate blood flow to the heart and improve the hearts ability to pump blood. EECP therapy uses pneumatic cuffs to constrict the blood vessels of lower extremities, which, in turn, increases the blood flow to the heart.

Ecp & Eecp Reimbursement

has experienced many changes in reimbursement since first approved by Medicare in 1999. Providers of ECP and have discovered that policies for reimbursement can vary from one region to another as does payment from one carrier to another.

With great anticipation to the Affordable Care ACT, many providers of ECP and EECP Therapy wonder how the current healthcare changes will affect their payments in 2014. We are pleased to announce that after final review, the final reimbursement rates for 2013 are quite positive. The overall payment rates for External Counterpulsation therapy remain virtually the same only fluctuating 3%-5%.

Reimbursements impact for 2014

There is no question that payments in Cardiology are changing in the U.S. With so many cuts in diagnostic imaging , ECP Therapy still remains a sound investment. In our estimation, ECP and EECP will remain a sound investment in the future due to the nature of the treatment being effect at a much lower cost to Medicare and insurance companies. ECP is also protected in a sense because the treatment is generally provided exclusively in Cardiology and the treatment cannot be abused. As a safe, low cost treatment option for many cardiac patients, we predict this year to be another successful year for patients and providers of ECP and EECP Therapy.

ECP & EECP Reimbursement Suggestions for 2014

For more information about patient eligibility criteria, please visit

Read Also: What Are The Medicare Open Enrollment Dates For 2020

Atraumatic Procedure Bypasses The Bypass For Patients With No Other Hope

The Health Care Financing Administration in Baltimore has extended Medicare coverage as of July 1 to enhanced external counterpulsation , the noninvasive, atraumatic outpatient treatment for patients with coronary artery disease . Coverage includes patients with disabling angina who, in the opinion of a cardiologist or cardiothoracic surgeon, are not readily amenable to surgical interventions such as angioplasty or bypass. Often candidates have undergone multiple invasive procedures that either failed or no longer suffice, and additional interventions may be too risky or refused by the patient. The procedure can also be used before a bypass or angioplasty when they are not unequivocally indicated.

The Medicare reimbursement for EECP has not been established, but experts estimate it will be $7,000 per full treatment course one-third typical charges associated with angioplasty and one-sixth those for bypass surgery . Because EECP carries almost no risks or complications, costs over time are also kept down.

But that point structure for EECP has not yet been established, and HCFA has delegated that decision to providers in the field. “Were all in the process of talking with the HCFA claims administration office in each jurisdiction to understand what the cost inputs are,” says Caton. “Then, they will be broken down into the point system, and well know what the allowable charge is.”

Eecp And Congestive Heart Failure

Why External Counterpulsation (ECP or EECP) benefits patients with Chest Pain and Coronary Calcium

According to the American Heart Association, there are currently 5 million individuals in the U.S. who suffer from CHF and 550,000 new cases are diagnosed each year. Heart failure results when the heart cannot pump enough blood to meet the needs of other organs. Subsequently, fluid retention and other changes take place, causing heart function to gradually worsen. The International EECP Patient Registry reports that EECP is safe and improves exercise capacity and quality of life in about 70 percent of heart failure patients who undergo treatment.

You May Like: Is Skyrizi Covered By Medicare

Picking The Right Patients

Karen Manzo, RN, clinical director of HeartCare Centers of Ohio says, “Patients eligible for EECP must be in Canadian Cardiovascular Classification 3 or 4.” HeartCare uses the New York Heart Association classification for congestive heart failure patients and the CCC classification for CAD. “They also must have a clinical condition that warrants them unsuitable to have bypass surgery or other surgical intervention.”

When Manzo submits for reimbursement, she lists the disqualifier that makes a patient inoperable or puts him at high risk for operative complications. “Sometimes a patients coronary anatomy may not be amenable to an operative procedure,” she says, “or he may have a comorbidity that creates risk, such as cancer or a pulmonary problem.”

HeartCare does about 20 EECP procedures a day. “Until Medicare covered this, patients usually self-paid,” says Manzo. “It is typically a seven-week course, 35 hours in all but occasionally, if the patient comes from a distance, two one-hour sessions are given in a day. Theres no data on the benefit of twice-a-day vs. once-a-day therapy.”

Chronic Cerebrovascular Occlusive Disease

The authors stated that this study had several drawbacks. First, only a small number of participants were recruited. In order to fully elucidate the potential of the techniques, data are needed for a higher number of clinically stable and asymptomatic patients, with mostly ipsilateral impaired auto-regulatory reserve. Second, the majority of the study population was men thus, it would be important to recruit a more genderbalanced cohort for future investigations. Furthermore, prospective longterm and multi-center studies are needed in order to analyze whether ECP has a sustained effect on CBFV and TOI. Finally, functional analyses following treatment with ECP are needed to evaluate any improvement in cognitive function and compensatory vascular re-modeling processes.

Also Check: What Is The Monthly Premium For Medicare Plan G

What To Expect At Treatment

  • At each session, you will lie on a cushioned exam bed and a technician will place large blood pressure cuffs around the legs and buttocks.
  • These cuffs are timed to inflate and deflate between your heartbeats. An EKG runs for the duration of the visit and is used to set the timing of the cuffs so they inflate when the heart is at rest and deflate just before the next heartbeat.
  • You will wear a sensor on your finger to measure the oxygen level in your blood and the pressure waves created by the cuff’s pulsation.

Why Isnt Eecp Used More Often

EECP Therapy in Pakistan

The cardiology community has largely chosen to ignore such an unconventional form of therapy, and many cardiologists fail to even consider offering EECP as a therapeutic option. Consequently, most people with angina never hear about it.

That’s unfortunate, as it doesn’t seem unreasonable to allow patients with stable angina to opt for a trial of a noninvasive therapy, perhaps even before they are pushed into invasive therapy, when:

  • A noninvasive treatment exists
  • It’s safe and well tolerated
  • It’s supported by available evidence that strongly suggests the treatment is quite effective in many
  • Those being treated can tell pretty definitively whether it substantially reduces angina symptoms

If you’re being treated for stable angina and still have symptoms despite therapy, it’s entirely reasonable for you to bring up the possibility of trying EECP therapy. Your healthcare provider should be willing to discuss this possibility with you, objectively and without prejudice.

Also Check: Is The Watchman Device Covered By Medicare

Medicare Increases Rates For Vasomedical Eecp Therapy For 2008

This increase results in a total national average physician fee payment rate of $5,465.60 for a typical 35-hour course of therapy. Changes in the national average physician fee payment for 2008 were a result of the rollback of the planned decrease in the physician dollar conversion factor and an increase in the practice expense portion of the Relative Value Units for EECP therapy.

The national average reimbursement rate for EECP therapy administered in the hospital outpatient setting also increased for 2008 to $109.47 per session, or 2.3 percent higher than the rate for 2007. This increase results in a national average hospital outpatient payment rate of $3,831.45 for a typical 35-hour course of therapy. Medicare payment rates for physicians and hospitals are adjusted according to a provider�s location within the United States.

For more information: www.vasomedical.com

Vasomedical Positioned To Seek Increased Reimbursement Coverage For Eecp Therapy

Board of Directors Expanded in Key Areas

WESTBURY, N.Y.—-Vasomedical, Inc. , a global provider of medical devices, today announced the execution of a definitive agreement with Edgary Consultants LLC to facilitate its effort to broaden reimbursement coverage of EECP® therapy, a proprietary technology for the treatment of certain cardiovascular diseases, with commercial third-party payers as well as Centers for Medicare and Medicaid Services .

EECP® therapy received initial coverage by Medicare in 1999 and since, has benefitted tens of thousands of patients every year in the United States. The Company and independent researchers have conducted extensive research, including several sham-controlled randomized studies, as well as numerous publications in peer review medical journals around the world. We have evaluated the science behind EECP® and have concluded the timing is right to seek additional reimbursement coverage for a cost effective alternative in the treatment of cardiovascular disease, stated Edgar G. Rios, President and the principal shareholder of Edgary. Mr. Rios is a co-founder and was Executive Vice President, General Counsel and Director of AmeriChoice Corporation from its inception in 1989 until its acquisition by UnitedHealth in 2002. In conjunction with its agreement with Edgary Consultants LLC, Vasomedical appointed Mr. Rios to its Board of Directors.

About Vasomedical

Don’t Miss: What Medicare Coverage Do I Need

How Does Eecp Work

EECP uses compressed air to inflate three sets of cuffs that are wrapped around the patients calves, lower thighs and upper thighs while he or she lies on the treatment table. The cuffs are inflated and deflated in sequence once during each heartbeat to squeeze blood up into the heart. ECG electrodes are placed on the patients upper chest to identify the timing of the inflation/deflation sequence. Treatment sessions are for one hour, five days a week for seven weeks. Some patients may need additional treatment hours. After EECP treatment, you may find that: You can walk farther, carry heavier packages, and be more active without having angina. You have fewer attacks of angina Your episodes of angina are less intense You need less anti-anginal medication You can return to work, go out to dinner, garden, travel, or enjoy golf or bowling once again You no longer restrict your social life, volunteer activities, or exercise because you are worried that they will cause angina EECP has an important role in augmenting the collateral blood flow to the heart muscle in those with compromised circulation.

Eecp Therapy For Chronic Stable Angina

Vasomedical EECP Inside Business Video Segment

For patients with chronic, stable angina, EECP®, or Enhanced External CounterPulsation Therapy, has been shown to provide some relief of chest pain and other symptoms and help patients to increase their daily activities. EECP Therapy kamagra is an option for patients who are not eligible for further interventional treatments for their condition, such as stenting or bypass surgery, says cardiologist Michael Morrow, M.D. It is an outpatient treatment available in our office that is usually given for an hour each day, five days a week, for a total of 35 hours. So it does require a significant time commitment from the patient to get the most benefit from the therapy.

During the treatment, you lie on a comfortable treatment table, in our spa-like EECP Suite, with large blood pressure-like cuffs wrapped around your legs and buttocks. These cuffs inflate and deflate at specific times between your zaleplon heartbeats. A continuous electro cardiogram is used to set the timing so the cuffs inflate while the heart is at rest, when it normally gets its supply of blood and oxygen. The cuffs deflate at the end of that rest period, just before the next heart beat. The special sensor applied to your finger checks the oxygen level in your blood and monitors the pressure waves created by the cuff inflations and deflations. During the therapy, patients relax and watch TV or sometimes nap.

Don’t Miss: Do Doctors Have To Accept Medicare Advantage Plans

Three Centers Involved In Chf Study

HeartCare, along with two other centers in the United States the University of Pittsburgh and the University of California at San Francisco is currently involved in a clinical study of EECP for CHF patients. “We are looking at 40 patients with CHF and the safety of their undergoing EECP,” says Manzo. There is no data yet.

EECP is thought to promote a natural bypass around blocked heart vessels and has been shown to be most effective in patients who have single- or double-vessel disease.

The procedure uses hemodynamic principles to relieve angina by increasing coronary blood flow to ischemic areas of the myocardium. It involves a series of compressive air cuffs placed on the patients legs and buttocks. Timed by the patients EKG signal, a microprocessor controls inflation and deflation of the cuffs at specific points during the cardiac cycle. During diastole, the cuffs sequentially compress vascular beds, creating a retrograde pressure wave and increasing perfusion pressure, blood flow, and oxygen supply. During systole, the cuffs are deflated simultaneously to produce unloading, decreasing oxygen demand. Patients often begin to experience alleviation of angina after 15 to 20 hours of the recommended 35-hour regimen. The beneficial effects are sustained between treatments, and may persist long after completion of a course of therapy.

More articles

Popular Articles