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Medicare Eases Access to Treatment for Leaking Heart Valves

June 30, 2020, 9:48 PM

Doctors would have more options for treating nearly 3 million patients with leaking heart valves as part of a Medicare coverage proposal announced Tuesday.

The Centers for Medicare & Medicaid Services proposed an updated National Coverage Decision that would allow transcatheter edge-to-edge repair for patients with functional mitral regurgitation. The transcatheter edge-to-edge repair is a noninvasive procedure that clips together the heart’s loose mitral valves.

The first coverage decision for this procedure took effect in 2014.

Functional mitral regurgitation patients have dysfunctional or diseased ventricles that prevent their valves from sealing properly. There are few treatment options for the condition, according to CMS Administrator Seema Verma.

The disease affects between 1.6 million to 2.8 million in the U.S. according to latest data.

“We recognize that patients with functional MR have limited treatment options beyond medical therapy and we believe this decision provides them with access to a new treatment option that may lead to improved health outcomes,” Verma said.

The agency wants to allow doctors to provide the procedure to Medicare patients without joining a registry or to participating in a clinical study.

To contact the reporter on this story: Ayanna Alexander in Washington at aalexander@bloomberglaw.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloomberglaw.com; Andrew Childers at achilders@bloomberglaw.com

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