The CMS National Coverage Determination (NCD) expands coverage for transcatheter mitral valve repair (TMVR) to include patients with secondary (or functional) mitral regurgitation (MR) resulting from heart failure.
According to an Abbott news release, the CMS decision significantly increases the number of people eligible for insurance coverage for mitral valve repair with MitraClip. Abbott said the revision is critically important to secondary MR patients as most impacted by MR are older, while several would be required to pay out of pocket for the procedure, creating a barrier of access.
“Secondary mitral regurgitation generally impacts older individuals suffering from heart failure who rely on Medicare for their healthcare coverage,” Abbott structural heart business chief medical officer Dr. Neil Moat said in the release. “CMS’ decision to expand coverage for MitraClip marks a pivotal moment for people seeking a minimally invasive option that reduces mitral regurgitation and significantly improves their quality of life and chances of survival.”
MitraClip is delivered to the heart through a vein in the leg and clips portions of the leaflets or flaps of the mitral valve together to reduce the backflow