CMS Announces Formal Consideration for Coverage of Cardiac Rehabilitation for Chronic Heart Failure

CMS (Centers for Medicare & Medicaid Services) has received a formal request submitted by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of

Cardiology (ACC), American Heart Association (AHA), and Heart Failure Society of America (HFSA) for a national coverage determination (NCD) to add the diagnosis of chronic heart failure (CHF) to the list of approved indications for coverage for cardiac rehabilitation (CR). The addition of any cardiac indication for coverage of CR must be done through the NCD process. Therefore, CMS has posted its intent to conduct a national coverage analysis (NCA) to complete a thorough review of the evidence to determine if Medicare beneficiaries would benefit from this additional qualifying diagnosis to current coverage policy.

There is a 30-day public comment period from 6-4-13 through 7-4-13. CMS is requesting public comment on the clinical evidence of health benefit outcomes, both short and long term, provided by this service to Medicare beneficiaries with the diagnosis of CHF. CMS is particularly interested in comments that include published clinical studies and other scientific information that provides evidence for improvement in short and long term outcomes related to this service for the diagnosis of CHF.
Click here for the National Coverage Analysis (NCA) Tracking Sheet for Cardiac Rehabilitation (CR) Programs – Chronic Heart Failure (CAG-00089R3).

AACVPR does not discourage individuals from submitting comments. More importantly, we anticipate that comments are consistent with those submitted by AACVPR, ACC, AHA, and HFSA in the formal request, posted on the above web page. After the 30-day public comment period, the typical time frame would be for CMS to then follow with a proposed Decision Memo (late 2013) and a final coverage regulation by early 2014.