National Coverage Analysis (NCA) View Public Comments

Intensive Cardiac Rehabilitation (ICR) Program - Dr. Ornish's Program for Reversing Heart Disease

Public Comments

Commenter Comment Information
Bocchino, Carmella Title: EVP, Clinical Affairs and Strategic Planning
Organization: America's Health Insurance Plans (AHIP)
Date: 06/10/2010
Comment:

June 11, 2010

Louis B. Jacques, MD
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mail Stop C1-09-06
7500 Security Boulevard
Baltimore, Maryland 21244-1850

Dear Dr. Jacques:

Thank you for the opportunity to comment on the Centers for Medicare and Medicaid Services' (CMS's) proposed national coverage decision (NCD) Intensive Cardiac Rehabilitation (ICR) Program - Dr. Ornish's Program for Reversing

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Lui, Karen Title: Government Affairs
Organization: American Association of Cardiovascular and Pulmonary Rehabilitation
Date: 06/10/2010
Comment:

CAG-00419N

The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) agrees that published reports, including those listed in the Proposed Decision Memo for ICR, published May 14, 2010, provide evidence of the beneficial outcomes from the Ornish Program for the select group of coronary artery disease patients they have studied.

We applaud efforts in comprehensive risk-reduction interventions that demonstrate the importance of lifestyle in the secondary

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Jones, David Title: President Institute for Functional Medicine
Date: 06/09/2010
Comment:

Dear Medicare:

The recent passage of healthcare access reform (Patient Protection and Affordable Care Act) will now require rigorous application of public health lifestyle interventions from k thru 12 in our school systems as well as lifestyle medicine interventions including re-education of physicians regarding the clinical evidence for primary prevention and secondary remediation of chronic, complex illnesses. Dr. Ornish''s program for reversing heart disease using the

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McKnight, damien Date: 06/03/2010
Comment:

THIS PROGRAM SIMPLY SAVES LIVES AND SAVES DOLLARS. IT ADDRESSES THE "HEART" OF THE PROBLEM AND DOESN''T JUST SLAP A BANDAID ON A GUSHING WOUND. COMPARED TO OPEN HEART SURGERY AND ANGIOPLASTY, THIS PROGRAM TEACHES PEOPLE HOW TO CARE FOR THEMSELVES AND FEEL BETTER AND STAY HEALTHY IN THE LONG RUN. PEOPLE IN THIS PROGRAM ALSO CAN LOWER OR STOP THEIR MEDICATIONS WHICH SAVES MEDICARE COUNTLESS DOLLARS. PLEASE APPROVE THIS PROGRAM ASAP!

Jonas, Wayne Title: President/CEO
Organization: Samueli Institute
Date: 06/01/2010
Comment:

I strongly support the CMS proposal to add the Ornish Program for Reversing Heart Disease to the list of approved ICR programs. The Ornish Program has been refined over the years but continues to focus on comprehensive lifestyle modifications, including exercise, a low-fat diet, smoking cessation, stress management training and group support.

It is clear that health and disease are a continuum and we know the fundamental elements that move us along that continuum. The basic elements of

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Wyden, Ron Organization: United States Senate
Date: 05/31/2010
Comment:

June 1,2010

The Honorable Kathleen Sebelius
Secretary, U.S. Department of Health & Human Services
Hubert H. Humphrey Building
200 Independence Avenue, S.W., Room 61S-F
Washington, DC 20201

Dear Secretary Sebelius:

I write to lend my support for the Centers for Medicare & Medicaid Services' May 14 national coverage determination for the Ornish Program for Reversing Heart Disease to be included under the intensive cardiac

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Curran, Peter Title: Director of Cardiovascular Rehabilitation
Date: 05/31/2010
Comment:

As a practicing cardiologist frustrated by the reimbursement emphasis on disease treatment instead of health maintenance, I unequivocally support Dr. Ornish's program and think this response from CMS is long over due.

Hill, James Title: Director, Center for Human Nutrition
Organization: University of Colorado Denver
Date: 05/31/2010
Comment:

I am Director of the Center for Human Nutrition at the University of Colorado Denver and have been continuously funded by the National Institutes of Health since 1891 to study lifestyle and health. I am enormously enthusiastic about the decision to recommend that the Ornish Program for Reversing Heart Disease meets the intensive cardiac rehabilitation (ICR) program requirements set forth by Congress in §1861(eee)(4)(A) of the Social Security Act and in regulations at 42 C.F.R.

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Marlin, MD, Ruth Title: Associate Director
Organization: Northern California Melanoma Center/St. Mary''s Medical Center
Date: 05/28/2010
Comment:

I have worked intimately with this program in the past and have been involved in training health professionals to provide this program for patients with heart disease, diabetes, cancer and obesity. This is an excellent, tested method for guiding people to make comprehensive lifestyle changes. I have seen hundreds of people benefit from this approach both in terms of improvement in health and quality of life, without expensive and life threatening procedures and medications. This approach

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Jimenez, Vernon Date: 05/28/2010
Comment:

I am writing this using my daughters computer. Iam 78 years old and find the prevention arm ofMedicare severely lacking. How could you notprovide coverage for a program (Ornish) that hasshown a high efficacy as well as cost reduction.

This is important public policy, finally you arepaying attention to the importance of diet,lifestlye and exercise as disease prevention.

PLEASE pass this!

Barnard, Neal Title: President
Organization: Physicians Committee for Responsible Medicine
Date: 05/28/2010
Comment:

May 28, 2010

Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services

Re: Proposed Decision for Intensive Cardiac Rehabilitation (ICR) Program – Dr. Ornish’s Program for Reversing Heart Disease (CAG-00419N)

Dear Centers for Medicare and Medicaid Services:

As a physician and founder of the Physicians Committee for Responsible Medicine, I am pleased to see your proposed decision to add the Ornish Program for Reversing Heart Disease to

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Merritt-Worden, Terri Title: Vice President- Wellspring
Organization: Siverton Hospital Netword
Date: 05/26/2010
Comment:

The Silverton Hospital Network strongly supports Centers for Medicare and Medicaid Services (CMS) proposed ruling to include the Dr. Dean Ornish Program for Reversing Heart Disease as a covered program for Intensive Cardiac Rehabilitation (ICR). We commend CMS in taking steps to provide coverage for comprehensive lifestyle intervention, which we have found to be a successful, evidence based intervention for those wishing to have a long term positive effect their cardiovascular disease

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Kemp, Colleen Date: 05/26/2010
Comment:

I''ve been a practicing registered nurse for 30 years and I''ve worked with the Ornish lifestyle modification program for 7 years. I''ve witnessed first hand how powerful and transformational these comprehensive lifestyle changes can be.

This program is a comprehensive and scientifically proven approach to preventing and treating lifestyle-related disease. This program expands choice for patients, providing a much needed non-invasive and pro-active treatment option.

I

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Cosgrove, MD, Delos Title: Chief Executive and President
Organization: Cleveland Clinic
Date: 05/24/2010
Comment:

May 25, 2010

Louis B. Jacques, MD
Director, Coverage and Analysis Group
Center for Medicare and Medicaid Services
200 Independence Avenue, SW
Wash ington, DC 2020 I

Dear Dr. Jacques:

Cleveland Clinic (CC) is a not-for-profit, integrated healthcare system dedicated to patient care, teaching and research. Our health system is comprised of a main campus, ten community hospitals and 14 family health centers with over 2,100 salaried physicians

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Perelson, Glenn Date: 05/24/2010
Comment:

Thank you for your decision to cover Dr Ornish''s Program for Reversing Heart Disease.

We are in the process of building an Accountable Care Organization in Sacramento with a health plan and a hospital system - adding an Intensive Cardiac Rehabilitation Program is an essential piece to help slow stop and reverse heart disease.

When given the right support, as in an intensive cardiac rehabilitation program, patients are able to better self manage their health.
Glenn

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Oz, Mehmet Date: 05/24/2010
Comment:

Comments for Memo for Intensive Cardiac Rehabilitation (ICR) Program – Dr. Ornish’s Program for Reversing Heart Disease (CAG-00419N)

To: CMS Comments

From: Mehmet Oz, M.D.

Date: May 19, 2010

Re: Comments for Memo for Intensive Cardiac Rehabilitation (ICR) Program – Dr. Ornish’s Program for Reversing Heart Disease (CAG-00419N)

My team and I would just like to support the decision for the proposed coverage decision of Louis B. Jacques, M.D., et al of May 14, 2010 and believe that

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Guarneri, Mimi Title: Medical Director
Organization: Scripps Health
Date: 05/23/2010
Comment:

As a practicing cardiologist I have had first hand experience using the Ornish program in very ill cardiac patients. Vegetarian diet, exercise, stress management and group support along with other Integrative Medicine strategies should be available to all patients.Cardiovascular disease is reversible. Lifestyle change can and does impact the risk factors of diabetes,obesity inflammation, dyslipidemia,stress and hypertension. This is a great step for the medical community.

Hyman, Mark Title: Chairman
Organization: Institute for Functional Medicine
Date: 05/22/2010
Comment:

Mark Hyman, MD
Chairman, Institute for Functional Medicine
45 Walker Street
Lenox, MA 01240

To Center for Medicaid and Medicare Services:

Comment on: Intensive Cardiac Rehabilitation (ICR)Program - Dr. Ornish''s Program for Reversing HeartDisease: (CAG-00419N)

Most of the chronic diseases that affect 160million Americans and accounts for 78% of ourhealth care costs are caused by a few lifestyleand environmental factors – namely our diet,sedentary lifestyle,

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Demas, Antonia Title: President, Visiting Scholar
Organization: Food Studies Institute, Johns Hopkins School of Public Health
Date: 05/22/2010
Comment:

It is with great pleasure that I recommend that CMS cover Dr. Dean Ornish’s pioneering lifestyle program for reversing heart disease. Dr. Ornish’s program is the most comprehensive and scientifically proven approach to preventing lifestyle-related disease in the country and I applaud your efforts to support it. Many lives and much heartache (both physically and emotionally) will be saved by CMS support.

As an educator who has worked for many years with at-risk children and their families,

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Goessler, Mary Title: Medical Director Medical Performance Management
Organization: Highmark Inc
Date: 05/21/2010
Comment:

I wholeheartedly support the inclusion of the Ornish program under Medicare coverage. As a medical director for a health plan I have seen several seniors benefit immensely from participating in Ornish which is covered currently under Highmark''s Medicare Advantage plans SecurityBlue and FreedomBlue. Participant''s have had significant improvement in their cholesterol, LDL, HDL, improved quality of life, reduction of blood pressure and reduction of the need for medications. This coverage

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Carmichael, Keith Title: Mr
Organization: Retired
Date: 05/21/2010
Comment:

I enrolled in Dr Ornish''s reversal program at CAMC in early 2004, after heart attack and 4 bypasses, and have followed the program since then. I am now 72 and feel fitter than before the heart attack. No hospitalization or other serious medical problems in this period. BMI now 25 and has been stable for several years. I have remained a member of the local self-directed group after the 12 month hospital program and believe that continuing contact with other participants has

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Anderson, Kelly Title: RN
Organization: Charleston Area Medical Center
Date: 05/21/2010
Comment:

I am a Registered Nurse of 21 years and have been working in the Cardiac Rehab field for 13 years. In working with the Ornish Program for the past 8 years, I have seen incredible outcomes in patients who have participants in the ORnish Program. It has dramatically improved the lives of patients with heart disease as well as those who are at risk for heart disease. They are healthier because of their lifestyle changes. They are at less risk for coronary events as well as dramatically

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Harshbarger, Dave Title: Wellness Manager
Organization: Health Sciences campus of WVU
Date: 05/20/2010
Comment:

As a provider of the Ornish Program in WV, I see first hand the need to cover our citizens who need this service the most. WV has more citizens per capita on Medicare than any state. We also have one, if not the, highes incident of heart disease. It would seem only right to provide coverage for this service. Dave Harshbarger

Leaf, Alexander Title: Jackson Professor of Clinical Medicine, Emeritus
Organization: Harvard Medical School
Date: 05/20/2010
Comment:

Dear Sirs,

I have read the article by Dean Ornish. It is excellent. I have known Dr. Ornish for many years since he was a student of mine when I was Chief of Medicine at Harvard Medical School. I know very well the paper by Dr. Ornish of which you are requesting advice from experts in this field. His paper is excellent as I stated.

There is no question in my mind, but that his paper should be accepted as important and acurate.

I trust you will accept my evaluation

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Marino, Robert Title: retired hospital CEO
Date: 05/20/2010
Comment:

[PHI Redacted] This program gives hope to cardiac patients and, to my knowledge, is the only program that can reverse heart disease and save lives and costs to the healtcare system.

Snyderman,M.D., Ralph Title: Chancellor Emeritus
Date: 05/20/2010
Comment:

I write is strong support of the Proposed Decision Memo-Dr. Ornish''s Program for Intensive Cardiac Rehilitation(ICR) Program for Reversing Heart Disease(CAG-00419N). This program and Dr. Ornish''s work and research have rewritten our understanding of the development of cardiovascular disease. Despite initial skeptisism, he has conclusively demonstrated the dynamic and reversible nature of coronary artery atherosclerosis. His program consisting of dietary modification, healthy life-style

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Marciniak, Mary Date: 05/20/2010
Comment:

Dr. Ornish''s program is a lifesaver. I cannot give enough credit to Dr. Ornish and his program, and the life-changing benefits of nutrition and stress reduction. This should be a part of every medical school program - teaching nutrition and how food is medicine. The importance of reducing stress in our lives, especially with technology we live with today cannot be understated. How we can heal ourselves - this could help end the health care crisis - if we can get politics out of it.

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Lewis, Heidi Date: 05/18/2010
Comment:

Wonderful!! Finslly a lifestyle change change rehabilitation program. Eventually this will save Medicare money by decreasing repeat procedures and teaching people how to be proactive with their health and not reactive.

Richardson, Diane Title: Staff Assistant
Organization: West Virginia University Hospitals - The Wellness Program
Date: 05/17/2010
Comment:

I am for coverage of this program for Medicare and Medicaid Services to their patients. This is a much needed program for those with this coverage. There is not a day that goes by that I have to tell a patient who calls that this program is not covered for them. Usually when they call me they are at their last resort to find something that will help instead of having surgery.

Harshbarger, Dave Title: Wellness Manager
Organization: WVU Hospitals
Date: 05/17/2010
Comment:

As a provider of the Ornish Program at West Virginia University Hospitals, it is a challenge to offer this program due to the small # of insurers covering this program. It is an amazing program with stellar outcomes. WV has more residents on Medicare per capita than any state. It is my hope we can offer this wonderful service to more West Virginians who need this.

Sincerly, Dave Harshbarger

Ruxton, Roberta Date: 05/16/2010
Comment:

[PHI Redacted] has participated in Dr Ornish''s Program for Reversing Heart Disease and has had remarkable results. Although we live in Florida he travelled to Pennsylvania to participate. Medicare would be smart to include this program in it''s programs to assist folks in health outcomes. It is a far better idea and it works than medications and surgeries....It need however a continued support link to assist clients in maintaining their training.

pridemore, betty Date: 05/15/2010
Comment:

Rehab AND prevention programs that have been PROVEN to work will cut costs dramatically. Ornish''s plan works to not only REVERSE but PREVENT heart disease and associated problems. Thsi is astep in the right direction.

Lee, Michael Date: 05/14/2010
Comment:

I am in full support of Dr. Ornish''s program beingreimbursed. It is first and foremost in the bestinterests of the patient, as it is a less-invasiveand more sustainable, longer-term approach toachieving greater health. In addition, it is alsoin the best interests of government spending, ascurrent invasive/expensive treatment options thatdo not attempt to alter lifestyle are 1.) ordersof magnitude more expensive and/or anatomicallyintrusive, and 2.) will invariably fail if thesource of

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