URGENT: Ask Congress to Tell Medicare to Preserve Your Ability to Get an Ablation

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

September 19, 2022

  • Summary: Ask Congress to Tell Medicare to Preserve Your Ability to Get an Afib Catheter Ablation
  • Reading time:  4–6 minutes

We need your help urgently!

Recently, we asked afib patients in the US to ask Medicare to preserve their ability to get a catheter ablation when needed. Unfortunately, that comment period closed in early September, but we have another opportunity to influence this. Congress can still submit comments until the end of September.

Therefore, you can make your opinion known to your Congressional representatives so they can comment to Medicare to reverse this onerous change.

This opportunity is easier than the previous one. That is because some electrophysiologists who are part of the EP Advocacy Foundation created a website to make it easy for you to send this message to YOUR Senators and House Representative. In addition, the Heart Rhythm Society, the electrophysiologist medical society, approved this website.

This article will give you the background about what happened and what you can do to quickly and easily make your voice heard.

Background

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.

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 great 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 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? Thus, there will be far fewer EPs. As EPs retire, there will not be new EPs to take their place.  

This whole debacle is a recipe for disaster. I heard some staggering statistics in a call with the Heart Rhythm Society (the medical society of electrophysiologists). 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.

What is most shocking, however, is that, apparently, Medicare made an egregious error in deciding on this reimbursement rate for afib catheter ablation. Here is what the Heart Rhythm Society said:

“It is our understanding that, in developing its recommendation, CMS errantly relied on a comparison to the time necessary for a dissimilar procedure – lower limb revascularization [a stent or balloon for peripheral artery disease]. The risk of working on an isolated area of the leg versus ablating tissue in a beating heart (with adjacent vital structures) seems incomparable from a clinical or patient perspective. For the sake of Medicare AF patients, an appropriate review should be conducted using relevant data that reflects the full scope of physician resources – including work, intensity, complexity, and necessary skill for cardiac ablation – with the goal of restoring payments to be more consistent with 2021 reimbursement.”

Can you even believe this? Truly shocking! An afib ablation does not compare to treatment for peripheral artery disease in the leg!

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. You don’t have to have had an ablation to share your thoughts—you only need to be an afib patient or a loved one concerned about getting care for a family member.

What You Can Do To Change This

We recently submitted comments to Medicare (CMS), and that comment period closed in early September. But, Congress can still submit comments until the end of September. So, you can help your Congressional representatives understand why this is so important and how they can comment to Medicare to reverse this onerous change.

If you would like to preserve access to this treatment option, please share your comments with your Senators and House Representative through the easy process below. It takes about a minute (or slightly more to personalize your message).

Go to https://www.saveablation.org/ and follow these simple steps:

  1. Scroll down the page (or click on a red button) to see your representatives listed. [If those are not your representatives, click on “Not your Reps?” to enter your address and click Submit to see the updated reps.]
    You may get a warning that the site is Safe but is new and asks for personal information; that will likely go away as more of us use it to submit our comments to Congress.
  2. Click “Edit and Send Email.”
  3. In the Subject line, select Healthcare from the list.   
  4. You can keep the boilerplate text or customize it as below.

    [Optional] Customizations could include your personal perspectives or experiences in a few sentences. You might put them somewhere after the first paragraph. Comments should be constructive, not critical. For example, you might mention some of the following:

    I am an afib patient (or caregiver or family member of an afib patient). I want to continue to have access to catheter ablation.

    Catheter ablation has improved my (or a loved one’s) quality of life and stopped my symptoms.

    Here are things I have been able to do due to having an ablation…

    I want to have access to a catheter ablation sometime soon.

    Not having access to a catheter ablation would hurt me in the following ways…

    Access to this life-enhancing procedure should be available to all afib patients. Unfortunately, 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.
  5. Click the “Continue” button, add your name and address (so your representatives know that you are a constituent), include your email address and phone number, and then click Send.

It’s that simple! Please do it NOW!

We’re grateful to the EP Advocacy Foundation, a leading voice for EP physicians, for creating this simple way for us to contact our Congressional reps about this critical issue.

If you have any questions, feel free to Contact Us.

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