CMS moves to speed Medicare approval for expanded uses of medical technology

Recent decisions on PET scans and defibrillators point to a new trend toward faster coverage, but with provisos for doctors.

By David Glendinning, AMNews staff. Oct. 25, 2004.

Washington -- Physicians who want Medicare to start paying for new uses of cutting-edge medical technology much more quickly than it has in the past could be finally getting their wish. But doctors had better be prepared to do some extra work for it.

Federal officials recently proposed expanding Medicare coverage of implantable cardioverter defibrillators (ICDs), which have been approved for more than a year for use in a limited number of patients with coronary disease. The Centers for Medicare & Medicaid Services anticipates that the list of qualified recipients will jump by one-third, to nearly a half-million as a result.

The ICD move comes right on the heels of another high-profile coverage extension. Medicare soon will begin paying for positron emission tomography scans when they are used to help diagnose some dementia patients who might have Alzheimer's disease.

CMS officials say that both decisions reflect a new commitment to speed the approval of medical technology for new uses within the Medicare community even if it has yet to be determined how much the recipients will benefit from the treatment.

In return, doctors prescribing preventive defibrillators to the new class of heart attack risk patients will be required to enter the seniors into a national registry for the purposes of further study. Physicians who want to order PET scans for people exhibiting signs of early dementia first must have the seniors enrolled in an upcoming CMS clinical trial on Alzheimer's disease.