Cardiac Device Coverage Updated by Center For Medicare Services

Cardiac device (ICD) coverage was updated last week by The Center For Medicare Services (CMS) for the first time since 2005. This update expedites patient access and cuts regulations for providers using the products.

The CMS is eliminating waiting periods for device implantation. It also dropped a policy that requires tracking and registering patients.

Cardiac Device: Patients Get Fast Service, Easy Access

The agency is speeding up access to ICDs by allowing patients with an existing cardiac device who suffer a heart attack to obtain a replacement device without waiting. Previously, the devices could not be implanted within 40 days of a heart attack or 90 days of bypass surgery or angioplasty. Hospitals have gotten into legal trouble for not honoring the wait period policy.

ICDs have been used since the 1980s, and the CMS began covering them in 1986. Initially, they were used in patients with recurrent cardiac arrest who were not responsive to drug treatments. In 2005, the agency finalized coverage for primary prevention of arrhythmia.

The devices are wired to the heart and deliver an electric shock if they detect an abnormal rhythm. They are a significant revenue driver for hospitals. It’s estimated that 10,000 ICDs are implanted every month, and the average hospital stay after placement is eight days. That generates an average of $12,423 in hospitalization costs per patient.