CMS Finalizes MRI Coverage For Patients with Cardiac Devices

Many Medicare patients with implanted pacemakers or cardioverter-defibrillators who meet certain criteria are now eligible to receive magnetic resonance imaging (MRI) under an updated national coverage determination released by the Centers for Medicare and Medicaid Services (CMS).

Earlier this year the ACC, along with the American College of Radiology, Heart Rhythm Society and Society for Cardiovascular Magnetic Resonance, sent a joint letter to CMS supporting proposed changes to expand MRI coverage for patients with implanted cardiac devices. Several specific changes recommended in the comments, including a minimum waiting period after device implantation, as well as abandoned leads and supervision standards, were included in the final decision.

The policy is effective as of April 10, but it could take several months for CMS and contractors to update claims processing protocols.

Taking on Administrative Burdens

The ACC recently joined the Regulatory Relief Coalition made up of several medical societies, including the American Academy of Ophthalmology and the American Society of Clinical Oncology, as part of its efforts to help members reduce burdens and clinical practice issues related to Medicare Advantage and Part D plans. As a next step, the coalition is specifically targeting obstacles related to prior authorization.

In addition to joining the new coalition, the College also recently submitted comments in response to questions from a group of U.S. senators led by Sen. Bill Cassidy, MD, (R-LA) regarding the reduction of unnecessary administrative burdens that contribute to clinician burnout; burdensome regulatory barriers that inhibit higher-quality and cost-efficient care; methods to better utilize Medicare and Medicaid data to improve quality outcomes, and more.

ACC Advocacy staff will continue to engage with legislators and stakeholder partners as these important efforts progress.

Click here to learn more about the ACC’s prior authorization efforts and access its Prior Authorization Reporting Tools (PARTools). These data collection tools are available to help track prior authorization issues associated with imaging procedures and prescription of PCSK9 drugs.