Category Archives: Health Insurance

Medicare Approves Drug-Coated Balloons for Outpatient Leg Angioplasty

Lutonix and IN.PACT drug-coated balloons

Last week saw the U.S. Centers for Medicare and Medicaid Services (CMS) approve reimbursement for the two drug-coated balloons that recently were approved by the FDA: C. R. Bard’s Lutonix and Medtronic’s IN.PACT.

C. R. Bard’s Lutonix drug-coated balloon (DCB) was approved in October 2014, while Medtronic’s IN.PACT Admiral was approved in January of this year. Both devices have shown superior results when compared to uncoated balloons (a.k.a. “plain old balloon angioplasty” or POBA). Continue reading

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Filed under Back to the Future, Endovascular, FDA, Health Insurance, History, Innovators, Peripheral Artery Disease (PAD), Video

Will a Denial of Service DOS Attack Hit New York State Medicaid Patients? Or Perhaps Your State?

  What does a Denial of Service Attack have to do with stents, angioplasty and PCI?

In the world of computing, a DOS attack is defined as “an attempt to make a machine or network resource unavailable to its intended users.” Typically netbots programmed by hackers overwhelm the web servers of banks, credit card providers, etc. whose sites then become unavailable to their customers. Now it seems similarly that in New York State, cardiovascular treatments may become unavailable to some Medicaid patients: a denial of service. Continue reading

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Filed under ACC, Appropriate Use Criteria (AUC), Cost Effectiveness, Health Insurance, Interviews, Media Coverage, SCAI

No New FDA Approvals Today!

FDA Website today (click for larger image)

FDA website today (click for larger image)

Obviously, with the Federal government in shut down mode, a situation precipitated by the House of Representatives’ demand to delay the implementation of the already-implemented Affordable Care Act (a.k.a. Obamacare), no new device approvals will be forthcoming today, or any other day, until the U.S. Government gets an infusion of start-up capital (puns intended).

Maybe a Kickstarter campaign would be in order here. Continue reading

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Filed under FDA, Health Insurance

NEJM: Obama and Romney on the Future of Health Care

Barack Obama and Mitt RomneyPublished “online first” today in the New England Journal of Medicine are two articles, authored by the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, describing their health care platforms and their visions for the future of American health care. The editors of NEJM had asked the nominees for these statements which are brief and concise, summing up the two positions in less than 1,300 words each.

President Obama’s statement, titled “Securing the Future of American Health Care,” recaps the highlights of the Affordable Care Act, passed in his first term, and lays out plans for future improvements. Continue reading

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Filed under Cost Effectiveness, FDA, Health Insurance, Patients

Stents, Angioplasty and PCI: The Uncertainty Principle (MEDICARE Style)

Is This Stent Necessary?The question of the day, regarding whether or not to stent a coronary artery, is now being brought to the forefront by the U.S. government in the form of a Medicare “Demonstration Project”. And by “brought to the forefront”, I mean MONEY! — as in “we won’t pay you if we determine that the stent procedure was inappropriate.”

The bottom line is that, on November 15, CMS announced “New Demonstrations to Help Curb Improper Medicare, Medicaid Payments“. These so-called “demonstrations” will occur in 11 states where claims “historically result in high rates of improper payments”: Florida, California, Michigan, Texas, New York, Louisiana, Illinois, Pennsylvania, Ohio, North Carolina and Missouri. Continue reading

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Filed under Appropriate Use Criteria (AUC), Cost Effectiveness, Health Insurance, Media Coverage