CMS proposes coverage updates for artificial hearts and ventricular assist devices

The Centers for Medicare and Medicaid Services announced compensation guidelines changes for patients with advanced heart failure including artificial heart and ventricular assist devices. The proposed policy change would remove the requirement for artificial hearts to be “covered with evidence creation,” and requires local Medicare Administrative Contractors to make coverage determinations for artificial hearts.

WHY IT MATERS?
The technology can be used to save people’s lives, according to CMS. Every year, between 4,000 and 4,500 heart transplants are performed each year, according to a study in the Journal of Thoracic Disease .

According to CMS Administrator Seema Verma, both artificial hearts and ventricular assist devices can be used as treatment for about 6.5 million American adults living with heart failure.

The new regulation would amend the coverage requirements for ventricular assist devices to better comply with existing medical practice, thus encouraging patients and clinicians to select the right care for them.

According to CMS, the planned ventricular aid upgrade will only apply to Left Ventricular Assist Devices (LVADs).

“To match patient inclusion requirements derived from massive, randomized controlled trials,” says the proposed law. "We recommend updating coverage conditions. “While retaining the adequate safety profil, this will extend coverage to more LVAD candidates likely to benefit from LVAD use.”

ON THE RECORD

"With around 6.5 million American adults living with heart failure, This plan provides a patient-centered approach to end-stage heart disease treatment without delaying care," CMS administrator Seema Verma said. Read More In The Source