The CMS said it intends to cover the implantation of left ventricular assist devices (LVADs) as permanent support for Medicare patients in end-stage heart failure. In a memo outlining its intent to make the change, the agency said only hospitals that had implanted at least 15 LVADs between Jan. 1, 2001, and Sept. 30, 2003, would qualify for payment. Meanwhile, eligible patients would not be candidates for heart transplants and would meet criteria established by a National Institutes of Health clinical trial. Medicare currently pays for LVAD implantation as a temporary bridge to heart transplant or as temporary support after open-heart surgery. The Food and Drug Administration approved marketing of LVADs for the expanded use last November. Heart failure accounts for 5% to 10% of hospitalizations among Medicare beneficiaries. Read the CMS memo on its intent.
In other Washington news, lawmakers trying to negotiate a Medicare reform package tentatively agreed to have the federal government pay at least some costs of prescription drug benefits for "dual-eligibles," Medicare recipients who also qualify for Medicaid. Aides confirmed that the committee was close to an agreement but had not decided whether Medicare would cover prescriptions costs for all dual-eligibles or only some of them. About 6 million people are eligible for both programs. States currently shoulder the full cost of any drug benefit received by dual-eligibles, spending about $7 billion a year. -- by Tony Fong