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2020 | HFSA

CMS Updates Coverage Policies for Artificial Hearts and Ventricular Assist Devices (VADs)

Practice News Advocacy

In September, HFSA, in collaboration with the Society of Thoracic Surgeons (STS), the American College of Cardiology (ACC), and the American Association for Thoracic Surgery (AATS), submitted comments on proposed changes from the Centers for Medicare and Medicaid Services (CMS) to coverage policy for artificial hearts and ventricular assist devices (VADs). The comment letters expressed opposition to the elimination of national coverage for artificial hearts and related devices while supporting the proposal to eliminate the unnecessary distinction between bridge-to-transplant and destination therapy for coverage of durable VAD implantation.

Previously, Medicare covered artificial hearts under the “coverage with evidence development” standard. The updated coverage policy announced this week will end this requirement for artificial hearts and instead allow for the more standard coverage determination process where coverage decisions are made by local Medicare Administrative Contractors (MACs).  The final national coverage determination also provides updated coverage criteria for VADs that better aligns with current medical practice and will expand coverage to a greater number of candidates who are likely to benefit from this technology