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CMS Expands Coverage for Defibrillators
The Centers for Medicare & Medicaid Services announced plans to lift the delay in its expansion of
Medicare coverage for implantable cardioverter defibrillators (ICD). The move will increase the
total number of beneficiaries eligible for ICD coverage by about a third, to 500,000. Of the newly
eligible seniors, Medicare officials expect at least 25,000 to take advantage of the benefit in
the first year. The projected federal cost of outfitting all seniors who are expected to get ICDs
is about $3 billion.
Physicians who prescribe the devices for the new class of Medicare patients must enter outcomes
data on the recipients in a national registry aimed at determining how well the treatments work.
CMS delayed its decision last December, citing the fact that a National Institutes of Health study
on ICDs and sudden cardiac death had not yet been published in a peer-reviewed medical journal.
The results of the investigation appeared in the Jan. 20 New England Journal of Medicine.
Sudden death from a heart attack, often touched off by a rapid, irregular heartbeat known as an
arrhythmia, accounts for roughly 50 percent of all heart disease deaths. About 450,000 people die
in the United States each year of sudden cardiac arrest. An ICD, which is implanted in the chest,
monitors the patient's heart rhythm and delivers an electrical shock when it detects a life-threatening
arrhythmia.
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