The Centers for Medicare & Medicaid Services (CMS) has announced its proposal to expand coverage for cardiac rehabilitation services to three additional groups of patients.
Following an extensive evidence review, CMS proposed in a notice posted on its website on December 22, 2005 to expand national coverage for cardiac rehabilitation to Medicare beneficiaries who have had heart valve repair or replacement, percutaneous transluminal coronary angioplasty (PTCA), and heart or combined heart-lung transplant.
“With this proposed coverage decision, CMS seeks to expand coverage to a greater number of beneficiaries with cardiac illness,” said CMS Administrator Mark B. McClellan, MD, PhD. “But just as importantly, we hope that our proposed decision will raise the public’s awareness regarding cardiac rehabilitation services in general.”
CMS further proposes that cardiac rehabilitation services 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.
“Today’s proposed decision is the result of an extensive evidence review on this very important topic, about which we have engaged several experts in the field, including our own Medicare Coverage Advisory Committee,” said Barry Straube, MD, Acting CMS Chief Medical Officer and Acting Director of the Office of Clinical Standards and Quality.
Medicare has covered cardiac rehabilitation services for beneficiaries following heart attack, coronary artery bypass surgery, and angina since the 1980s and this coverage will continue.
Details of the proposed coverage policy are available for review at the CMS coverage website at www.cms.hhs.gov/coverage/. CMS encourages the public to respond to the Agency’s proposed decision by submitting public comments directly to the Coverage web site. Comments will be accepted for 30 days following the posting of the proposed decision memorandum. CMS will issue a final decision within 60 days of the close of the comment period.