Extensive training, expert treatment and board tests are all requirements for becoming a sub-specialized cardiologist. Physicians take pride in their distinct area of practice and are sought out by patients and referring practitioners looking for skilled care. Most sub-specialties have been recognized by the Centers for Medicare and Medicaid Services (CMS) as specialty designations, enhancing each field’s ability to represent their profession and patients. Advanced heart failure and transplant cardiologists, however, have not been given this distinction.

To remedy this oversight, ACC’s Heart Failure and Transplant Section Leadership Council began working in tandem with the Heart Failure Society of America (HFSA) in an attempt to attain a CMS designation. Wanting to ensure excellence in their field, the group felt that gaining this designation would be an important step to more effectively treating heart failure and transplant patients while also recognizing their profession.

“This is important to me personally because it validates our specialty,” says Biykem Bozkurt, MD, PhD, FACC, chair of ACC’s Heart Failure and Transplant Section Leadership Council. “We, the advanced heart failure cardiologists, value and take pride in the care we provide and believe it is a unique practice with specialized training and expertise, as also recognized by other cardiologists referring their patients who seek our care.”

In March 2014, the group submitted justification criteria for why CMS should grant heart failure its own designation. These criteria outlined five main points, including advanced training requirements, rapid expansion of the field and the importance of proper training, guideline recommendations referring patients to heart failure cardiologists, CMS reimbursement requirements, and finally, recognition as a specialty. Although the points outlined were compelling, the initial CMS application was rejected.

Specialists were not pleased with this rejection and felt their specialty deserved as much recognition as any other field. “Similar to interventional cardiologists or electrophysiologists, advanced heart failure and cardiac transplant physicians want to be recognized for their specialized training, board certification, expertise and consultative services,” remarks Bozkurt. “Dismissal of such designation gave the impression that advanced heart failure and cardiac transplantation care can be provided by anybody or any cardiologist.”

Rather than become discouraged at this initial denial, the ACC and HFSA came together to form an appeal to CMS. The Council conducted a training, staffing and practice survey to strengthen the argument for heart failure as a specialty designation and support their arguments for growing numbers of specialists by providing numbers of board-certified heart failure specialists versus numbers of general cardiologists. The HFSA also worked to successfully obtain a taxonomy code for the specialty which takes effect Oct. 1, 2015. The hope is that by pulling together and taking these additional steps, the appeal will go through and the journey to a heart failure designation will be completed.

Bozkurt remains optimistic about the future, “Although there have been a few road blocks to getting our CMS designation, we are hopeful that our renewed efforts will prevail and our field and its physicians will get the recognition they deserve.”

Keywords: Cardiology Magazine, ACC Publications, Centers for Medicare and Medicaid Services, U.S., Heart Failure, Heart Transplantation, Medicaid, Medicare

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