URGENT ACTION NEEDED: Ask Medicare to Preserve Your Ability to Get a Catheter Ablation

Medicare’s Proposed 40% Payment Cuts for Electrophysiologists Will Make Afib Catheter Ablations Hard to Get

August 29, 2022

  • Summary: Catheter ablations will become hard to get, but you can preserve your access to them.
  • Reading time:  3–4 minutes

We need your help urgently!

If you are an afib patient on Medicare (in the US and 65 or more), this is scary as afib catheter ablations may become unavailable to those who need them. We need your help urgently to reverse this proposal by Medicare and preserve your ability to get an afib catheter ablation when and if you need one.

You may recall that last year we asked for your help when Medicare (CMS, the Centers for Medicare & Medicaid Services) proposed decreasing the payment that electrophysiologists would receive in 2022 for doing a catheter ablation. Many of you helped us by submitting your comments to Medicare about this.

Unfortunately, Medicare didn’t listen to us patients and went ahead with those cuts. Now, further emboldened, they propose even more significant cuts for 2023. We patients cannot let them get by with it as it will likely decrease our access to the care we need! WE MUST STOP THIS!

Between Medicare’s actual cuts last year and their proposed cuts for 2023, the cumulative decrease in payments to EPs for doing afib catheter ablations would be a draconian 40% cut! That would not only hurt EPs, it would also hurt afib patients.

As you know, doing an afib catheter ablation takes a great deal of skill. These skills can take a decade or more to develop. But Medicare doesn’t want to reimburse EPs for what it takes to do afib catheter ablations. This wouldn’t even pay for an EP’s time doing a thorough afib catheter ablation. They want to remove the incentive to do it right by not covering the time it takes, and we cannot let that happen!

This huge disincentive will have disastrous results for afib patients because of the following actions that will likely result from these cuts:

  • Existing EPs will be reluctant to do catheter ablations as they can make more by doing other procedures.
  • Afib catheter ablations will be harder to get, and waiting lists will get longer and longer and longer. This will be a massive disservice to afib patients by making access to ablations much harder.
  • The low reimbursement rates will result in some EPs completely abandoning doing afib catheter ablations, which will further lengthen waiting times.
  • With payments slashed dramatically, what doctor will want to invest the time to specialize and become an EP, so there will be far fewer EPs. As EPs retire, there will not be new EPs to take their place.  

This is a recipe for disaster. I heard some staggering statistics in a call with the Heart Rhythm Society. Currently, in the US, there is one electrophysiologist for every 6,500 afib and arrhythmia patients. The number of afib patients is expected to double by 2030. If the number of EPs doing catheter ablations decreases as expected (likely up to half), that could mean one EP for every 25,000 afib and arrhythmia patients. That would be the worst ratio in the developed world and mimic the developing world.

If that happens, waits for ablations will stretch to years and be devastating for afib patients.

Has having a catheter ablation improved your quality of life? Would you like to continue to have access to a catheter ablation?

If you think you may ever want an afib catheter ablation, then the time to act is now to preserve your ability to get one when you need it.

Medicare is accepting comments from those who would be affected by this change. You don’t have to have had an ablation to comment; you only need to be an afib patient or a loved one concerned about getting care for a family member.

If you would like to preserve access to this treatment option, please provide comments to Medicare no later than September 6, 2022.

Once there, follow these simple steps that should take 2–5 minutes for you to submit your comment.

  1. In the Comment field, mention that you are an afib patient. Express your concern that Medicare is considering changes that could affect the ability of afib patients to get a catheter ablation.

    Share your personal perspectives or experiences in a few sentences. For example, you might mention how a catheter ablation has improved your (or a loved one’s) quality of life, how it stopped your symptoms, what you have been able to do as a result of having an ablation, how you want to have access to a catheter ablation sometime soon, or how not having access to a catheter ablation would hurt you.

    You could also mention that access to this life-enhancing procedure should be available to all afib patients and that few physicians are trained and qualified to perform this highly-specialized procedure (especially in underserved communities). Thus, it is vital to ensure fair reimbursement to allow all afib patients equitable access to ablation.

    All comments should be constructive, not critical. Feel free to modify and include the verbiage I’ve shared below (in italics) in your comments, or include something similar in your own words. [If it looks like a boilerplate, they may discard it, so please customize it to you.]

    Medicare has proposed cuts for electrophysiologists doing afib catheter ablations. Unfortunately, this will make it difficult for us afib patients to get a catheter ablation.

    As an afib patient, I request that Medicare withdraw the planned cuts and pay EPs appropriately for these procedures to preserve our access to afib catheter ablations.
  2. Select a Comment Category—select “Individual” from the drop-down box.
  3. Attach a file if you prefer to submit a longer statement.
  4. Enter your Email Address, and if you’d like a confirmation, click the checkbox.
  5. For Identity, select the box that says “An Individual.”
  6. Check the “I’m not a robot” box.
  7. Click Submit Comment.

If you have any questions, feel free to contact us using this link: Contact Us

It’s time for us to mobilize and protect our right to access the treatments we need.

It only takes 2-5 minutes to share why this is so important to you and to all afib patients.

The deadline to submit comments is September 6, so please do this NOW. Don’t put it off.

If Medicare enacts this, you may not be able to get a catheter ablation when you need one. So please ask Medicare to withdraw the planned cuts and keep paying EPs appropriately for doing ablations.

To read the details of the proposed rule change, see https://www.regulations.gov/document/CMS-2022-0113-1871.

PS. I had the privilege of sitting down with Roderick Tung, MD for Heart Rhythm TV to talk about the effect that this would have and how important it is for us afib patients to mobilize to preserve our ability to get access to this vital care. Watch the full video interview here (Mellanie’s interview starts at 3:42).