New CMS ICD App Combats Future DOJ & RAC Investigations of Hospitals for Improper ICD Implantation Procedures

Published by: Andrew Paul    |   Category: Medical News    

Since the release of the CMS ICD Application on January 17th, 2013 to ensure that 100% of patients screened meet the evidence-based criteria for ICD, CRT-P, and CRT-D implantation devices, Think Tank Medical is now offering hospitals a private, dedicated version of the CMS ICD Application to distribute to all doctors, cardiologists and electrophysiologists within their facilities. This managed system will give each hospital, ACS, or Specialty Medical Facility access to the entire backend reporting system and enable physicians to send real-time reports to compliance officers to ensure that all cardiac implantation procedures comply with CMS (Center for Medicare & Medicaid Services) guidelines. Furthermore, it will provide hospitals the documented surety that their employed physicians are prudent in their determination of patient eligibility or ineligibility of cardiac-related implantation devices.

A study published by the National Cardiovascular Registry has determined that 22.5% of all ICD implantations in the United States have failed to meet medical necessity as dictated by Medicare’s National Coverage Determination guidelines. Furthermore, approximately 50% of patients who would otherwise be qualified for an ICD do not get such a device implanted. Since the publication of this study, the DOJ (Department of Justice) has begun to heavily scrutinize hospital ICD implants that were implanted between 2003 and 2010 and have launched a series of internal investigations on a large number of institutions to review all claims for payment of ICD procedures. Having identified nearly $1.03 billion in inappropriate payments, CMS has been employing Recovery Audit Contractors(RACs) to issue penalties and fines to hospitals in an effort to recover these improper Medicare payments. CMS announced a new “Recovery Audit Contractor Prepayment Demonstration Program,” that began in the summer of 2012 and allow Medicare auditors to review claims for specific procedures performed prior to authorizing payment. Florida has provided a list of 15 DRGs that require prepayment medical reviews, and these DRGs include ICDs, pacemakers, stent implantations, PCI procedures without stents, and other vascular and circulatory-system procedures, as well as some noncardiovascular procedures. When you consider that the billable cost of implanting an ICD device can range between $30K-$40K and the penalties and fines for performing ineligible procedures often result in three times the amount in damages for each claim, hospitals can open the door to huge liabilities and become subject to major financial losses associated with noncompliant procedures.

With some hospitals now facing millions of dollars in fines and chargebacks, it is more critical than ever before to ensure more stringent measures are taken to avoid inappropriate procedures and enforce compliance with Medicare guidelines. By deploying the CMS ICD application to all cardiologists and electrophysiologists within their facilities, hospitals can take a proactive approach to eliminate non-compliant procedures, avoid DOJ investigations, CMS audits, provide a better quality of care for their patients, and help save lives.

Andrew Paul, Founder of Think Tank Medical states, “The primary goal for the release of a private, managed system available for hospitals is to ensure that all ICD, CRT-P, and CRT-D devices are being utilized only when medically necessary. With the application’s capability to determine a patient’s eligibility in under a minute, re-evaluate patients who fall into mandatory waiting periods, to send notifications to the doctor and specified hospital personel to schedule follow-up appointments, and to send eligibility test results to the doctor and compliance officer, every patient determination is well-documented. Also, select hospital administrators will have access to the backend reporting system, which will provide full transparency into all tests conducted by their physicians. That being said, any and all federal violations laying claims against hospitals for procedures that failed to follow the guidelines will be mitigated with clear, legitimate documentation.”

The complete list of features and benefits of the CMS ICD application can be found at

Think Tank Medical is supported by a team of dedicated professionals and knowledgeable experts in the design, development, and marketing of healthcare-related mobile phone applications, websites, and software. Think Tank Medical distinguishes itself by creating web-enabled products and services that fully comply with CMS guidelines and guarantee significant cost reductions in an industry that is facing an increasing number of government regulations.

The experienced professionals at Think Tank Medical capitalize on new trends in the Healthcare Industry and work to provide stakeholders technologically advanced, yet user friendly solutions that improve the quality of healthcare. The ultimate goal is to extend life in patients through the promotion of less invasive treatment options and earlier diagnoses.

For additional information, please visit our website at

The CMS ICD App can be downloaded directly from iTunes by searching “CMS ICD” in iTunes or by following this link: CMS ICD App Download


Andrew Paul
Think Tank Medical
Phone: 561.988.9996
Fax:     561.826.6050
info (at) thinktankmedical (dot) com

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