Medicare Might Revise Coverage of Certain Implantable Devices


The Medicare agency is heading toward possible coverage changes for certain implantable heart devices for the first time in a dozen years.

The Centers for Medicare & Medicaid Services is reviewing (in analysis number CAG-00157R4) how implantable cardioverter-defibrillators (ICDs) are covered under Medicare. The agency said the review came from within the agency, not an external party. An industry group for medical devices praised the CMS’s efforts. “We think it’s overdue, it’s definitely time to revisit this,” Chandra Branham, vice president of payment and health-care delivery policy at the Advanced Medical Technology Association, told me Aug. 10.

ICDs are battery-powered devices that treat abnormally fast, life-threatening heart rhythms by delivering a shock to the heart, restoring the heart’s normal rhythm and preventing cardiac arrest. In order to receive Medicare reimbursement for ICDs, providers must submit data sets to the CMS that provide more information about the safety and effectiveness of the device.

ICD coverage determinations haven’t been updated since 2005, and hospitals and device groups say an update is long overdue.

Read my full article here.

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