CMS Proposed Expanded TMVR Coverage With Many Other Changes

CMS has released a long-delayed proposed coverage decision for mitral valve transcatheter edge-to-edge repair (TEER). CMS’s Proposed Decision Memo revises covered indications to add secondary/functional mitral regurgitation (FMR).

For degenerative mitral regurgitation (DMR), CMS is proposing to let local coverage policies govern what DMR procedures are covered. This includes requirements for a medical team and participation in a registry. Local Medicare Advantage Contractors would be able to set more restrictive or less restrictive policies (including no requirements at all).

SCAI is working with ACC and the surgical groups to develop a response by the June 30^th deadline.