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CMS to expand coverage of implantable cardiac devices

Patient Financial Services Weekly Advisor, January 21, 2005

CMS said January 19 it will expand coverage for implantable devices that can help prevent sudden death from heart failure and certain types of heart disease, according to The New York Times.

CMS Administrator Mark B. McClellan said the agency was "poised to expand" coverage of the devices based on new research that indicates they could increase the chances of survival in a large number of elderly Medicare beneficiaries.

"This policy change may increase the number of Medicare beneficiaries who are eligible for an ICD [implantable cardioverter-defibrillators], to more than 500,000, two to three times the number who are currently eligible," McClellan said in an article in The New England Journal of Medicine.

Medicare pays about $30,000 for each patient who receives an implantable device. McClellan said just 20%-25% of those who are currently eligible actually receive the devices.

Medicare beneficiaries make up 80% of sudden deaths from heart problems in the United States.

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