MEDICARE ANNOUNCES ITS EXPANSION OF COVERAGE FOR CARDIAC REHABILITATION SERVICES
The Centers for Medicare & Medicaid Services (CMS) today announced it will expand coverage for cardiac rehabilitation services to three additional groups of patients.
Following an extensive evidence review, CMS is expanding national coverage for cardiac rehabilitation to Medicare beneficiaries who have had heart valve repair or replacement, percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting, or a heart or combined heart-lung transplant.
While the evidence on the benefits for congestive heart failure is not sufficient for a coverage expansion at this time, ongoing studies are likely to provide more certainty about the impact of cardiac rehabilitation for these patients.
CMS determined that cardiac rehabilitation services should be comprehensive and include medical evaluation, education, and nutrition services. Evaluation of the current medical evidence demonstrated a greater benefit to patients when services were provided in such a comprehensive manner.
“The decision to cover three new clinical indications and provide a comprehensive set of services when treating cardiac rehabilitation patients is consistent with the medical evidence,” CMS Administrator Mark B. McClellan, MD, PhD, said. “This expansion of coverage for rehabilitation will give many more patients with heart disease access to proven treatments to restore a higher quality of life.”
Medicare has covered cardiac rehabilitation services since the 1980s for beneficiaries following heart attack, coronary artery bypass surgery, and angina, and this coverage will continue.
Details of the final national coverage determination announced today are available for review at the CMS coverage website at http://www.cms.hhs.gov/center/coverage.asp.