January 3, 2006
Washington Report
Advocacy Efforts Change WELLPOINT Policy on A-Fib Ablation!
Dear Heart Rhythm Society Member,
The Heart Rhythm Society, working in conjunction with the ACC, responded and strongly objected to Wellpoint’s policy on "Transcatheter Ablation of Arrhythmogenic Foci in the Pulmonary Veins as a Treatment of Atrial Fibrillation" published in November. Wellpoint’s original draft policy stated that "Transcatheter ablation of arrhythmogenic foci in the pulmonary veins is considered investigational/not medically necessary as a treatment of atrial fibrillation".
This would have meant this procedure would not be covered or reimbursed by Wellpoint, one of the nation’s largest insurance providers. Wellpoint provided an opportunity for the professional societies to comment before widespread implementation. Heart Rhythm Society and the ACC successfully worked together to overturn this restrictive policy. In December, Wellpoint published a change to the policy. The new policy states:
"Transcatheter radiofrequency ablation of arrhythmogenic foci in the pulmonary veins is considered medically necessary as a treatment of atrial fibrillation when the patient:
- Is symptomatic; AND
- Is resistant to two (2) or more antiarrhythmic drugs (or has intolerance of or a contraindication to appropriate antiarrhythmic drug therapy).
Investigational/Not Medically Necessary:
Transcatheter radiofrequency ablation of arrhythmogenic foci in the pulmonary veins is considered investigational/not medically necessary as a treatment of atrial fibrillation in ANY of the following circumstances:
- As a first-line treatment of atrial fibrillation,
- In the absence of resistance to two (2) or more antiarrhythmic drugs (including the absence of intolerance or contraindication to appropriate antiarrhythmic drug therapy),
- Asymptomatic atrial fibrillation."
If you have comments or questions on the policy please contact Lisa Miller at 202-464-3400 or lmiller@hrsonline.org
To view the Wellpoint policy, please click here.
Sincerely,
Anne B. Curtis, MD, FHRS
President
Heart Rhythm Society
