On Feb. 15, the Centers for Medicare and Medicaid Services (CMS) released a final national coverage determination (NCD) policy governing implantable cardioverter-defibrillator (ICD) implantation for Medicare fee-for-service patients. In a notable change from the draft NCD released last November, the required shared decision-making encounter must involve a tool, but does not need to be completed in a separate formal encounter with an "independent" clinician. This change comes in response to feedback provided by ACC President Mary Norine Walsh, MD, FACC, and Heart Rhythm Society President George F. Van Hare, MD, FHRS, FACC, in a public comment letter after the draft NCD was released. Walsh and Van Hare wrote that shared decision-making "has long been an integral component of patient care in electrophysiology programs across the country." The NCD also ends the requirement for data collection for evidence development, which sites have satisfied through participation in ACC's ICD Registry, but CMS "encourage[d] the continuation and improvement of a voluntary registry for purposes of quality improvement, safety and appropriate use verification.” Read more on ACC.org.