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History
COCA was formed on January 13, 2006 when forty-five cardiologists, administrators, and cardiac cath lab operators attended the inaugural meeting in Nashville, TN. The primary impetus for this meeting was a Proposed Decision Memo issued by the Centers for Medicare and Medicaid Management (CMS) in October 2005 to repeal the National Coverage Determination (NCD) for cardiac catheterization performed in other than a hospital setting, citing insufficient evidence to determine if net health outcomes of cardiac catheterizations performed in non-hospital outpatient cath labs (OPCLs) are comparable to cardiac catheterizations performed in the outpatient hospital setting. CMS recommended that cardiac catheterization in a OPCLs be covered at the discretion of local Medicare carriers.
As a result of this meeting, the attendees agreed to establish a national organization to represent OPCLs on a wide range of issues to CMS and other entities. Since the CMS justification for the repeal of the NCD was largely based on quality issues, the members decided that one of the primary purposes of
As the meeting concluded, the membership elected a Board of Directors, who in turn elected officers and established committees to work on quality initiatives and the reinstatement of an outpatient cath lab NCD. Work began on these critical issues when a new issue arose in February 2006 of such significance that
At a Town Hall meeting on February 15, 2006 CMS proposed revisions to the practice expense (PE) component of RVUs that would significantly reduce reimbursement for technology-based outpatient procedures in 2007 and beyond. However, the proposed impact on reimbursement cardiac cath procedures was so severe that if implemented, the reimbursement would fall significantly below the cost of performing the procedures and most OPCLs would be driven out of business.
After submitting comments to CMS concerning the proposed PE RVU changes, COCA worked to galvanize the cardiology community over the issue and build a consortium of advocacy groups such as the Cardiology Advocacy Alliance, Cardiology Leadership Alliance, and others. COCA has also worked with the ACC and SCAI to make them aware of the impact on our members and keep them informed of our activity.