Medicare News
| For Immediate Release: | Contact: |
| Wednesday, September 26, 2001 | CMS Office of Public Affairs 202-690-6145 |
For questions about Medicare please call 1-800-MEDICARE or visit www.medicare.gov. |
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MEDICARE WILL COVER HOME TESTING FOR BLOOD THINNESS
The Centers for Medicare & Medicaid Services (CMS) will begin national Medicare coverage of home testing that enables patients with mechanical heart valves to measure how well their blood is thinned.
Previously there had been no national coverage policy for self testing in the home prothrombin level (also called INR testing) for patients with mechanical heart valves, and the insurance companies that process and pay Medicare claims had been denying claims for home prothrombin self testing.
"This simple home test can help Medicare beneficiaries reduce their risks of strokes and bleeding," Health and Human Services Secretary Tommy G. Thompson said. "The decision reflects our commitment to expanding Medicare coverage to include effective preventive care and services."
"Once more, Medicare is moving aggressively to assure that beneficiaries get the high quality, and sometimes lifesaving, care they need and deserve," said CMS Administrator Thomas A. Scully. "This decision will give a new option to Medicare beneficiaries who need to get frequent prothrombin tests. The scientific data we reviewed showed that when patients with mechanical heart valves used these devices at home, they may suffer fewer strokes and bleedings."
Under local carrier coverage policies, patients receiving home health care could have their prothrombin level measured by home health personnel, and phlebotomists could come to patients' homes to draw samples that were processed in laboratories. The new national coverage policy allows beneficiaries to perform the test themselves and could permit more frequent monitoring of a patient's response to blood thinning medication.
After a review of the scientific and clinical evidence, CMS determined that the evidence regarding more frequent home testing was sufficient to provide national Medicare coverage for patients with mechanical heart valves.
The decision was posted on the CMS web site on Sept. 19, 2001. Implementation is expected later this year. More information on this coverage decision is available at http://www.hcfa.gov/coverage/8B3-PP.htm.
