CMS expands MRI coverage for patients with heart devices

MRIdian treatment planning
The Medicare agency has moved to expand coverage of MRIs to patients with an implanted cardiac device, without "evidence-based" restrictions. (ViewRay)

The Centers for Medicare & Medicaid Service (CMS) is making it easier for patients with certain implantable devices to get MRI scans. 

As part of a coverage decision, the federal agency is expanding MRI coverage for patients with an implanted cardiac device, without the need for "evidence development."

Medicare coverage for MRI services for such patients started in 2011, but only if the patients were part of a clinical trial, due to safety concerns. 

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"We determined that the evidence is sufficient to conclude that [MRIs] for Medicare beneficiaries with an implanted pacemaker, implantable cardioverter defibrillator, cardiac resynchronization therapy pacemaker, or cardiac resynchronization therapy defibrillator is reasonable and necessary for the diagnosis or treatment of illness or injury," the agency said.

The memo, however, did not specify an effective date for the finalized changes. The decision follows research released earlier this year by the New England Journal of Medicine that found MRIs safe for patients with cardiac devices. 

RELATED: Anthem alters controversial ER coverage policies

During the proposal stage, CMS considered not extending the coverage to patients who were pacemaker dependent and a six-week wait period after device insertion for any surgical modification. Both proposals were later dropped. 

MRIs are expensive, and private insurers have made attempts at moving patients away from the services in hospital settings—and caught flak for it. Last year, Anthem attempted to curb costs by steering patients towards freestanding imaging centers. After backlash from providers, the insurer walked back some parts of the new policy in February. 

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