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CMS Expands ICD Coverage In Long-Awaited Decision; Stakeholders Rejoice

This article was originally published in The Gray Sheet

Executive Summary

CMS' expansion of implantable cardioverter defibrillator Medicare coverage incorporates several recommendations from manufacturers and professional societies

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Medicare Agency Solicits Input On ICD Coverage For First Time Since 2005

The US Medicare agency opened a national coverage analysis to reconsider coverage indications for implantable cardioverter defibrillators and received input from 35 individuals, organizations, and companies during the initial public comment period. The agency did not specify any particular issues or deficiencies that it wants to address by updating its coverage policy, but CMS has not reconsidered the national coverage policy on ICDs since a major coverage expansion was implemented in 2005.

Only 8 Percent Of Older ICD-Eligible Heart Failure Patients Get An ICD, Study Finds

Improved patient follow up and communications may be needed to get implantable defibrillators to more patients who need them, researchers say following a recent study finding fewer than 10 percent of eligible patients with low ejection fraction received an ICD within a year after a heart attack, even though ICD implants were associated with lower risk-adjusted two-year mortality in this group.

AHRQ Tech Assessment Supports Primary Prevention Implantable Defibrillators

The agency affirms the evidence in favor of implantable defibrillators for primary prevention of sudden cardiac death is strong for patients with reduced left-ventricular ejection fraction, but does not support resynchronization ICDs for this population.

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