CMS finalizes coverage expansions for artificial hearts


CMS finalized Medicare coverage expansions Dec. 1 for artificial hearts and ventricular assist devices, which are used for patients with life-threatening heart failure.

Four things to know:

1. The changes, proposed in August, will allow artificial hearts to be covered without being linked to a clinical study. Before, Medicare only covered these artificial heart devices when beneficiaries were enrolled in a clinical study.

2. Coverage determinations for artificial hearts will be made by local Medicare Administrative Contractors.  

3. CMS said the final decision is "in the best interest of Medicare beneficiaries since careful patient selection is important, and the MACs are structured to take into account a beneficiary's particular clinical circumstances to determine which patients will benefit from receiving an artificial heart."

4. The coverage expansion took effect Dec. 1. 

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