On July 30, 2008, the Centers for Medicare and Medicaid Services (CMS) released a proposed list of topics for potential National Coverage Determinations (NCD) for public comment. The list, which will be released quarterly, includes catheter ablation for treatment of atrial fibrillation.

CMS is seeking public comment on the following:

“Ablation for atrial fibrillation: If medication is not effective or not tolerated for atrial fibrillation, a non-surgical procedure called catheter ablation may be chosen. Focal and circumferential catheter ablation for atrial fibrillation is still being studied in investigational trials but may be done in selected patients to try to cure atrial fibrillation. Is the evidence adequate to demonstrate health benefits in the patients who receive the procedure? “

The release of this information stems from CMS’ commitment to provide advance notice to the public regarding potential topics they are considering, and allow stakeholders to suggest additional topics for consideration, creating a more transparent and predictable NCD process, as published in the April 11, 2006, guidance document entitled "Factors CMS Considers in Opening a National Coverage Determination."

CMS is encouraging comments from the public regarding several procedures, as well as medical devices and drugs. Since ablation is a widely utilized off-label treatment for atrial fibrillation, the Society will comment on this issue and provide evidence to demonstrate that use of ablation devices improves health outcomes for Medicare beneficiaries. The deadline for comment is September 28, 2008.

After considering public comment, CMS will assess the evidence and determine whether a NCD is warranted. Until then, coverage for atrial fibrillation will continue to be covered at contractor discretion. The Society's Health Policy staff will continue to track this issue as it progresses and keep members informed of CMS’ decision.