Medicare Expands Coverage for MitraClip in Heart Failure Pat

Medicare Expands Coverage for MitraClip in Heart Failure Patients


Medicare Expands Coverage for MitraClip in Heart Failure Patients
New national reimbursement significantly expand access to transcatheter mitral valve repair procedures for secondary mitral regurgitation
January 20, 2021 — The U.S. Centers for Medicare and Medicaid Services (CMS) revised its National Coverage Determination (NCD) to expand coverage for the Abbott MitraClip to include patients with secondary (or functional) mitral regurgitation (MR) resulting from heart failure.
The procedure is known as transcatheter edge-to-edge repair (TEER), but is also referred to as transcatheter mitral valve repair (TMVR).
The CMS decision significantly increases the number of people eligible for insurance coverage for mitral valve repair with MitraClip, enabling broader access to the device. As the first TEER device approved by the U.S. Food and Drug Administration (FDA) and reimbursed by Medicare for primary mitral regurgitation, physicians have increasingly relied on the therapy to improve survival and quality of life for their patients. Today's decision improves insurance coverage for people with secondary MR who need treatment with MitraClip.

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