The recently revised Medicare coverage policy for implantable cardioverter-defibrillators (ICDs) requires patients to participate in a shared decision-making interaction with their physician or a designated nonphysician practitioner before undergoing a primary prevention implantation.1 This is the third instance in which the Centers for Medicare & Medicaid Services (CMS) has required shared decision making as a condition of coverage. CMS mandated shared decision making in 2015 for lung cancer screening with low-dose computed tomography and in 2016 for left atrial appendage closure (LAAC) for stroke prophylaxis in atrial fibrillation.2 CMS seems poised to extend mandatory shared decision making to other treatments and tests.
Merchant FM, Dickert NW, Howard DH. Mandatory Shared Decision Making by the Centers for Medicare & Medicaid Services for Cardiovascular Procedures and Other Tests. JAMA. 2018;320(7):641–642. doi:10.1001/jama.2018.6617
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