CMS makes coverage decision on MRI for blood flow

After a nine-month period of deliberation and public comments, the Centers for Medicare & Medicaid Services (CMS) has decided that the choice to reimburse an MRI exam for blood-flow determination should be left to the local Medicare contractor.

The agency found that the blanket non-coverage of MRI for blood-flow determination is “no longer supported by the available evidence.” The agency, therefore, will remove the phrase "blood flow measurement," from the Nationally Non-covered Indications, and local Medicare contractors will have discretion to cover (or not cover) this use.

In other news, the agency said it has not found evidence that MRI improves health outcomes in beneficiaries who have an implanted cardioverter-defibrillator (ICD) or cardiac pacemaker approved by the FDA for use in an MRI environment.

CMS added that there are currently no such devices.

Therefore, it will not change this provision of the National Coverage Determination Manual, and these exams will retain the current contraindications.

Also, an MRI exam is not covered for patients with metallic clips on vascular aneurysms, according to CMS.

The agency came to similar conclusion in early July, but conducted the standard three-month public comment period.




Around the web

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”

FDA Commissioner Robert Califf, MD, said the clinical community needs to combat health misinformation at a grassroots level. He warned that patients are immersed in a "sea of misinformation without a compass."

With generative AI coming into its own, AI regulators must avoid relying too much on principles of risk management—and not enough on those of uncertainty management.

Trimed Popup
Trimed Popup