The Centers for Medicare & Medicaid Services (CMS) announced on March 30 that additional hospitals may become Medicare approved for ventricular assist device (VAD) implantations.

The Agency is updating the requirements for VAD Destination Therapy facilities to include facilities that: 1) have a surgeon on their team with the experience of implanting at least 10 VADs or artificial hearts during the preceding 36 months; 2) submit data to the federally supported Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS); and 3) are certified by the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) through its newly established Disease-Specific Certification Program for VADs.

"This decision will improve access to this life-sustaining technology," said Acting CMS Administrator Leslie V. Norwalk, Esq, "and with Joint Commission certification we will ensure that patients receive care in experienced facilities."
Ventricular assist devices (VADs) are implanted mechanical devices used to assist a damaged or weakened heart in pumping blood. These devices are used in support of blood circulation post-cardiac procedures, while a patient is awaiting a transplant (bridge to transplantation) and when a patient requires permanent circulatory support (destination therapy). Today's announcement applies to facilities that implant devices under the destination therapy indication.

The Joint Commission submitted its VAD program standards to the Agency and formally requested that CMS review their standards to determine whether they meet the CMS facility requirements.

Previously, CMS approved facilities that met requirements outlined in a 2003 National Coverage Determination. These facilities will be required to meet the updated requirements and, within two years, become Joint Commission certified.

Details of the coverage policy are available at the CMS coverage website at http://www.cms.hhs.gov/mcd/viewnca.asp?where=index&nca_id=187&basket=nca:00119R:187:Ventricular+Assist+Devices+as+Destination+Therapy:Open:1st+Recon:9

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