MEDCAC Meeting 11/14/2012 - Management of Heart Failure with the Use of Ventricular Assist Devices
The Centers for Medicare & Medicaid Services (CMS) has convened this meeting for the panel to review available evidence on the use of ventricular assist devices (VADs), a clinical strategy for the management of heart failure. VADs are mechanical blood pumps that are surgically attached to one or both intact ventricles of a damaged or weakened native heart to assist in pumping blood.
Medicare currently provides coverage for VADs for three indications: postcardiotomy (after open-heart surgery); bridge-to-transplant (while patients await heart transplantation) and destination therapy (when patients are not candidates for heart transplantation). Patients must meet eligibility criteria which vary based on the indication for use. In addition, devices can only be implanted in facilities and by operators meeting criteria intended to ensure optimal health outcomes for Medicare beneficiaries.
This meeting will focus on how outcomes can be optimized for patients with heart failure, especially the appropriate selection of those who are likely to benefit from the placement of VADs and the facility and operator characteristics which predict improved health outcomes for patients receiving a VAD. It will also serve to identify areas where further research may be warranted, and include an evaluation of the generalizability of the available evidence to patients of different age, gender, and racial/ethnic backgrounds. Medicare addresses coverage of VADs in section 20.9 of the national coverage determination (NCD) manual (Pub. 100-03) entitled National Coverage Determination (NCD) for Artificial Hearts and Related Devices (20.9). The NCD is available at: http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=246
Medicare currently provides coverage for VADs for three indications: postcardiotomy (after open-heart surgery); bridge-to-transplant (while patients await heart transplantation) and destination therapy (when patients are not candidates for heart transplantation). Patients must meet eligibility criteria which vary based on the indication for use. In addition, devices can only be implanted in facilities and by operators meeting criteria intended to ensure optimal health outcomes for Medicare beneficiaries.
This meeting will focus on how outcomes can be optimized for patients with heart failure, especially the appropriate selection of those who are likely to benefit from the placement of VADs and the facility and operator characteristics which predict improved health outcomes for patients receiving a VAD. It will also serve to identify areas where further research may be warranted, and include an evaluation of the generalizability of the available evidence to patients of different age, gender, and racial/ethnic backgrounds. Medicare addresses coverage of VADs in section 20.9 of the national coverage determination (NCD) manual (Pub. 100-03) entitled National Coverage Determination (NCD) for Artificial Hearts and Related Devices (20.9). The NCD is available at: http://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=246
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