On January 26, 2011, Maryland's new health secretary briefed lawmakers that the state was contemplating legislative avenues to better regulate the use of cardiac stents in patients. The announcement came in light of an ongoing investigation into allegations that a local cardiologist may have implanted hundreds of potentially medically unnecessary stents from 2007 through mid-2009, costing the Medicare program approximately $3.8 million. This same physician also was linked in a recent U.S. Senate Finance Committee report to stent manufacturer Abbott Laboratories, which paid him for consulting work.
Maryland lawmakers are considering modeling legislation off Vermont or Massachusetts laws prohibiting gifts between drug and medical device companies and physicians. These laws require public disclosure of payments device manufacturers make to healthcare providers and limit the items sales representatives can offer physicians, including restrictions on trinkets, trips and most meals. Other options Maryland is considering include legislation providing for information-sharing among state agencies or creating an accreditation process for cardiology centers that perform stent procedures.
In releasing the Senate report, Senator Max Baucus (D-Mont.) stated "Doctors should not be performing invasive medical procedures patients don't need, and taxpayers certainly shouldn't be paying for these wasteful and improper implantations . . . Even more disconcerting is that this could be a sign of a larger national trend of wasteful medical device use, which is why we included aggressive new tools in the new health care law to fight fraud, waste and abuse." From year 2004 to 2009, Medicare paid an estimated $25.7 billion for cardiac stent procedures.
This potential movement in state law and the recent release of the Senate report indicates a continued national and state level focus on the medical necessity of cardiac stent placements.