In collaboration with the Society for Cardiovascular Angiography and Interventions (SCAI), and the Heart Rhythm Society (HRS), ACC Advocacy submitted comments to the Centers for Medicare and Medicaid Services (CMS) recommending changes to its draft national coverage determination for percutaneous closure of the left atrial appendage. These comments addressed each of the seven conditions proposed for coverage.

Particular emphasis was placed on CHADS2 and HAS-BLED scores, the definition of “contraindication” – given the U.S. Food and Drug Administration approval of the Watchman device for patients who can take Warfarin – institutional and operator requirements in line with the recent SCAI/ACC/HRS Institutional and Operator Requirements for Left Atrial Appendage Occlusion expert consensus document, and the proposal that registries collect data on “non-interventional control” patients.

CMS will now consider these and other comments from the public. A final decision memorandum must be issued and take effect by Feb. 8, 2016. ACC Advocacy will continue to keep members updated on the LAA coverage determination. 

Keywords: Angiography, Atrial Appendage, Centers for Medicare and Medicaid Services, U.S., Medicaid, Medicare, Registries, United States Food and Drug Administration, Warfarin

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