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CMS Announces FY 2015 New-Tech Add-On Payment Applicants

This article was originally published in The Gray Sheet

Executive Summary

Among the latest round of applicants announced Dec. 26 for the hospital inpatient, new-technology add-on payments are five device makers: Boston Scientific (Watchman), CardioMEMS (Champion HF), Abbott Vascular (MitraClip), NeuroPace (RNS), and Aptus Endosystems (Heli-FX EndoAnchor).

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Medicare Add-On Payments Granted For Cardiac, Neuro Devices

CMS agreed to grant new tech add-on payments to St. Jude’s CardioMEMS implantable heart failure monitoring system and Abbott’s MitraClip mitral valve repair system, but it took some convincing. The agency also granted an add-on for NeuroPace’s RNS responsive neurostimulator system to treat seizures.

CMS Skeptical Of Watchman, CardioMEMS Data For New-Tech Add-Ons

The Medicare agency is questioning whether Boston Scientific’s Watchman stroke device or the CardioMEMS implantable heart failure monitor, championed by St. Jude Medical, can meet the “substantial clinical improvement” threshold to qualify for an inpatient new-technology add-on payment.

TAVR Gets Love, MitraClip Gets None In Medicare Inpatient Proposal

CMS proposes to grant new hospital inpatient payment categories for transcatheter valve replacements, a potential boon to Edwards’ and Medtronic’s devices. But the Medicare agency continues to stand firm against upgrading payment levels for Abbott’s MitraClip percutaneous mitral valve repair procedure.

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