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Medicare Add-On Payments Granted For Cardiac, Neuro Devices

This article was originally published in The Gray Sheet

Executive Summary

CMS agreed to grant new tech add-on payments to St. Jude’s CardioMEMS implantable heart failure monitoring system and Abbott’s MitraClip mitral valve repair system, but it took some convincing. The agency also granted an add-on for NeuroPace’s RNS responsive neurostimulator system to treat seizures.

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St. Jude Taking CardioMEMS Message To Payers As Sales Lag Expectations

Sales of St. Jude Medical's CardioMEMS implantable heart failure monitor are lagging behind the firm's recent predictions. The company cites resistance from payers as the main challenge and executives say they are making a major push to educate insurers about the major cost savings the technology provides.

CMS Proposes Changes For Outpatient Device Pass-Through Payments

The Medicare agency wants to bring the process for awarding pass-through bonus payments to devices in the hospital outpatients more into the light of day, and also add criteria to ensure only devices approved within the prior three years can qualify. The proposals were made in the 2016 Medicare outpatient payment proposed rule.

Add-On Payment Accelerates Commercialization Of NeuroPace’s RNS

The company is focused on expanding the number of centers that use its responsive neurostimulator RNS system to treat seizures in patients with epilepsy, while eyeing other indications. It’s also partnering with the Defense Department on a memory restoration project.

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