Medicare Changes Plans to Cover Neck Stents

The Centers for Medicare and Medicaid Services (CMS) previously announced plans to provide coverage for placement of neck stents to limit strokes. Those plans were recently reversed.

The aboutface is purportedly in response to broad criticism leveraged by surgeons. Some are particularly surprised about the decision because the Medicare coverage will conflict with the FDA approval of indications for stents.

The FDA approval covers indications in patients who have carotid restriction greater than 80 percent without symptoms in addition to other groups of patients with active symptomotology. The CMS coverage will, instead, be limited to patients who have a blockage greater than 70 percent and are experiencing symptoms.

CMS’s decision is based on the lack of clear evidence to support stent placement. And the agency will still continue to cover devices placed in the context of approved clinical trials.

While some may be surprised, the decision represents the Agency’s commitment to support evidence-based practices. That’s not a bad stance for a federal agency that provides health coverage for more Americans than any other insurer.

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May 2, 2007 Related topics: Medical Devices & Products, Trends, Cardiology

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