Another cardiologist, this time in Tennessee, is being accused of unnecessary stenting, theheart.org reported last week. The Department of Justice is investigating accusations brought by a Jackson, Tennessee cardiologist against another Jackson cardiologist, Jackson-Madison County General Hospital, Regional Hospital of Jackson and a Jackson radiologist. The allegations state that the cardiologist overused cardiac services, including cardiac sonography, scintigraphic stress imaging, angiography, angioplasty and stenting, to defraud Medicare. The two hospitals and the radiologist condoned or assisted the cardiologist’s inappropriate use, according to the allegations.

This is one of a series of reports about abuse of cardiac services across the country. Hospitals and physicians in both Maryland and Pennsylvania have come under fire under similar claims. The abuse of services brings a bad name upon cardiology, sullying the reputation of the whole profession.

We need to prevent these abuses from happening. One way in which the ACC is doing so is by supporting the Society for Angiography and Interventions’ (SCAI) Accreditation for Cardiovascular Excellence (ACE). ACE offers formal, objective, and independent evaluation and monitoring of cardiac and endovascular interventional facilities to ensure that they meet the highest possible standards for patient care and safety. The purpose of this program is to ensure the removal of any perceived or real conflicts of interest in oversight of hospital and physician quality performance. ACE accreditation criteria also calls for use of registries like the National Cardiovascular Data Registry (NCDR) and adherence to appropriate use criteria (AUC) -- both of which are already widely accepted and respected by professional and regulatory communities nationwide. Last month, ACE accredited its first hospital – Bon Secours St. Francis Health System in South Carolina – for cardiac catheterization and angioplasty/stenting. Review of other hospitals’ lab programs is underway.

However, ACE alone would not have prevented the abuses alleged in Tennessee. Additional quality tools – such as appropriate use criteria, practice guidelines and other clinical documents – are needed. These quality tools can provide states, payers and purchasers of care with critical, transparent metrics with which to evaluate quality of care, especially necessary as the health care community shifts from a fee-for-service reimbursement model to one more focused on outcomes-based care and commensurate reimbursement.