When devices such as pacemakers and defibrillators malfunction or are recalled, manufacturers may refund part or all of the cost of the replacement based on how old it is. The CMS requires hospitals to pass the credits on to Medicare, which pays for the surgeries of replaced devices. Yet, providers can keep the credits if they are less than 50% of what the hospital paid for the replacement device, which can complicate things. In addition: only certain devices are eligible for credits; electronic health records are not equipped to track warranties; vendor requirements for claims vary by device; and vendor turnaround can take months, requiring coordination across a number of departments within a hospital.
"This impacts all health systems," Schafer said. "It's a very resource intensive process and requires a proactive approach to tackle it head on."
Cardiac rhythm implants such as pacemakers and defibrillators account for more than half of all Medicare overpayments, but warranty credits could also involve cochlear implants, neurostimulators and orthopedic implants, Schafer added.
The Warranty Tracker, which is in the pilot stage, is a centralized platform that aggregates the logistics workflow—estimating the eligibility of the return, tracking when the manufacturer receives the device and notifying on the credit outcome. The reason for the explant is logged in the EHR, the EHR sends an on-screen notification to return the device to the vendor, it sends automated alerts when the 50% threshold is reached and reconciles vendor credit reports with hospital records. This minimizes risk, reduces liability and creates a more efficient process, Casady said.
Providers are also using new tools to keep them informed of safety warnings and recalls when they are purchasing equipment and devices. Tracking such warnings can help health systems improve safety measures and save time and money by avoiding potentially dangerous devices, especially as organizations look to merge and scale up, said Michael DeLuca, executive vice president of technology and client services for healthcare supply chain technology company Prodigo Solutions.