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CMS Covers MADIT II Patients, Limits Coverage to Those with Wide QRS
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Category: News
After considering for one year the issue of MADIT II coverage for Medicare beneficiaries, the Centers for Medicare and Medicaid Services (CMS) issued its 'notice of intent' for MADIT II coverage on June 6th in a 31 page decision memorandum. CMS announces its intentions to expand ICD coverage to "patients with a prior myocardial infarction and left ventricular ejection fraction less than or equal to 0.30 and an electrical conduction abnormality in the heart (QRS) duration of greater than 120 milliseconds." In response to CMS' decision, NASPE issued a press release, stating that "NASPE/Heart Rhythm Society is concerned with CMS' ruling to make only select heart patients in the Medicare program eligible to receive implantable cardioverter defibrillators (ICDs). While we are pleased a national coverage decision has been made expanding ICD coverage to additional patients at risk of sudden death, we are disappointed with the restriction that limits implants to only those patients fitting this new indication category whose ECG shows an abnormally wide QRS duration (greater than 120 milliseconds). Because the restriction criteria are not based on published observations or peer review, we are concerned that the criteria are not scientifically sound". CMS indicated it will review this decision as new evidence becomes available, including the results anticipated later this year from the National Institute of Heart, Lung, and Blood Institute Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). CMS will issue instructions to Medicare carriers who process and pay Medicare claims before the new coverage becomes effective. This process can take up to six months. NASPE/Heart Rhythm Society will continue to work with CMS as it continues to look at findings from future studies and we will work with Medicare carriers to implement this policy expeditiously. If you have any questions, please contact Amy Melnick or Brian Outland in NASPE's Washington Office at 202-327-5430 2007 © Copyright Net Style - All rights reserved. | Privacy Policy