SCAI says CMS should boost stent payments

May 20, 2004

A new task force report from the Society for Cardiovascular Angiography and Interventions says current payment levels from the Centers for Medicare and Medicaid Services (CMS) for drug-eluting stent procedures are inadequate.

SCAI leaders called for reimbursement revisions as part of a comprehensive overview of drug-eluting stents, published in the latest issue of Catheterization and Cardiovascular Interventions (May 2004, Vol. 62:1, pp. 1–17).

Drug-eluting stents became commercially available in the U.S. as of April 2003. In the wake of studies showing that drug-eluting stents do a better job of inhibiting arterial restenosis than their bare-metal predecessors, the new technology is now widely used.

CMS' structuring of the diagnosis-related-group (DRG) payments for drug-eluting stents, meanwhile, has not kept up with the clinical and financial realities, the SCAI report suggested.

"SCAI strongly believes that the underlying data and assumptions CMS has incorporated into calculating the DRG relative weights for DRGs 526 and 527 have provided rates that significantly underestimate the true resource requirements for DES procedures," the report stated.

"CMS should not place financial pressures on hospitals that are not in the best interests of patients, especially in this situation where optimal utilization may reduce total Medicare costs," the authors concluded.

By AuntMinnie.com staff writers
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