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Thursday, July 08, 2010

Hippocratic Oath - mHealth


Disappointing news for someone who came in with a lot of promise. I can foresee kneejerk responses to this already. For starters the developed markets will look at regulating these devices in a more efficient manner than they are handled today (more so under healtheconomics and the FDAs). Secondly the bubble of mHealth will shrink in the minds of analysts. However, what is promising is that these regulations will move the drive for innovation out of the developed markets in the longer run leading to a lot of potential for innovation in emerging and less regulated markets.  

United Healthcare: CardioNet is “unproven”

Wednesday - July 7th, 2010

More bad news on the reimbursement front for CardioNet and other mobile cardiac outpatient telemetry service providers: United Healthcare told the company that it is maintaining its position that “outpatient cardiovascular telemetry is unproven for managing cardiac arrhythmias” and as a result it will not cover the service for its members. CardioNet, of course, disagrees and promised to continue to work with the payer to demonstrate the efficacy of its MCOT services.
The update from CardioNet about United Healthcare’s continued stance follows a similar move by the nters for Medicare and Medicaid Services (CMS) that proposed last week that the technical component of mobile cardiovascular telemetry (CPT Code 93229) remains carrier-priced for calendar year 2011.
Highmark CMS originally paid $1,123.07 for MCOT services when the CPT code took effect in early 2009, however, by July Highmark CMS announced plans to reduce the reimbursement rate substantially. On September 1, 2009 a new rate of $754 per service, a 33 percent reduction from the original $1,123, took effect. CardioNet was disappointed: “This surprise decision by HMS on July 10, 2009 must be readdressed and not be allowed to put at risk either the investment in new technologies or the benefit to the patients we serve,” the company wrote in a statement.
Since then the company has had to tighten its belt and cut operations costs to adjust for the lower reimbursement rate. The news that United Healthcare, one of the largest payers in the US, maintains its policy on not reimbursing for CardioNet’s services certainly points to the climate of wireless health reimbursement today.

2 comments:

  1. Hi,Dear
    This is really correct.....................
    The Hippocratic Oath

    ReplyDelete
  2. Thanks Alish. Also, good link you shared there.

    ReplyDelete