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SVS Leadership Engages with Pennsylvania Department of Health on new EV Guidance

Notice to SVS Members from the Executive Board:  

On Jan. 12, 2018 the State of Pennsylvania Department of Health (DOH) issued a new guidance limiting the number and type of endovascular procedures performed in free-standing outpatient facilities. Concerned members alerted the SVS to the new guidance and requested advocacy assistance. Upon further inquiry, the SVS discovered that the new guidance from the State of Pennsylvania also includes a routine "exception" process, allowing practices to submit outcome data demonstrating the quality and safety of their practices as well as suggest alternative process criteria supported by either internal data or literature.  If accepted, an exception would permit a practice to continue offering care. To date, about seven such exception requests have been received.

SVS has been monitoring these events carefully and opened a formal dialogue with the Pennsylvania Department of Health over the last three months. The Pennsylvania Department of Health expressed its concern with some observed poor outcomes for complex vascular procedures performed in free-standing facilities. Their concern relates to their public charge of preserving safety of patients and quality of care in these settings. The SVS reiterated its shared goals with the Pennsylvania DOH to ensure that all patients have the highest quality, the most appropriate and the safest care possible across all settings and reinforced the importance of ensuring that highly skilled, trained, well-staffed and resourced practices can continue to provide excellent care to patients.

The SVS is very encouraged by our discussions with the Pennsylvania Department of Health and believes that a path does exist that will improve the process, allowing all well trained interventionalists to provide high quality, safe and appropriate care in well-organized free-standing ambulatory facilities. We will pursue our discussions with the Pennsylvania DOH and hope to achieve a resolution in the coming months. We will keep you alerted to the progress of these discussions. In the mean time we encourage our Pennsylvania members to take advantage of the “exception program” until a final resolution is achieved.

The SVS suspects that other states may decide to enact similar programs, and would like to encourage all members to notify the SVS of any similar situations they may become aware of. The SVS is committed to advocate for all its members while maintaining our stated mission that all vascular care provided to patients, regardless of setting, must be optimized to achieve the highest level of quality, appropriateness, and safety.