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CMS Opens Coverage Analysis For Embattled Knee Injury Scaffold

This article was originally published in The Gray Sheet

Executive Summary

ReGen Biologics' Menaflex knee meniscus device is now under scrutiny at two government agencies

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Medicare In Brief

LVAD coverage analysis: CMS will consider whether to expand national Medicare coverage for ventricular assist device destination therapy to match recently updated FDA labeling for Thoratec's HeartMate II, the agency said Feb. 22. The coverage analysis was opened in response to a request by Thoratec, which gained PMA approval in January for its next-generation left-ventricular-assist device to keep alive end-stage heart failure patients who are not candidates for transplant (1"The Gray Sheet" Jan. 25, 2010). The FDA-indicated destination therapy population for HeartMate II includes a broader set of heart failure patients and a lower duration requirement for prior failed therapies than what was approved for Thoratec's older-generation HeartMate XVE, the device that formed the basis of the current Medicare destination therapy coverage policy established in 2003. CMS will issue a proposal by August 22 on whether to expand coverage and a final decision by Nov. 20. Comments are due March 24

Medicare In Brief

LVAD coverage analysis: CMS will consider whether to expand national Medicare coverage for ventricular assist device destination therapy to match recently updated FDA labeling for Thoratec's HeartMate II, the agency said Feb. 22. The coverage analysis was opened in response to a request by Thoratec, which gained PMA approval in January for its next-generation left-ventricular-assist device to keep alive end-stage heart failure patients who are not candidates for transplant (1"The Gray Sheet" Jan. 25, 2010). The FDA-indicated destination therapy population for HeartMate II includes a broader set of heart failure patients and a lower duration requirement for prior failed therapies than what was approved for Thoratec's older-generation HeartMate XVE, the device that formed the basis of the current Medicare destination therapy coverage policy established in 2003. CMS will issue a proposal by August 22 on whether to expand coverage and a final decision by Nov. 20. Comments are due March 24

Sen. Grassley Wants FDA To Give More Info To CMS, Cites Menaflex Case

Controversy over FDA's 2008 clearance of ReGen Biologics' Menaflex knee repair device has now expanded into questions from Congress over how effectively FDA shares information with its sister agency CMS

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