SCAI Town Hall: TAVR National Coverage Determination-SCAI Town Hall: TAVR NCD

Video Transcription

Video Summary

The town hall focused on SKy’s response to CMS’s reconsideration of the TAVR national coverage decision (NCD), which has shaped TAVR access and practice standards since 2013. Leaders explained that CMS initially asked only about expanding indications, especially for asymptomatic severe aortic stenosis, and whether coverage with evidence development (CED) should continue. SKy first gathered limited member feedback, then joined a multi-society letter, and later launched a broader survey after CMS announced a new comment period expected around June 15.<br /><br />Survey results showed strong support for change: 76% said the current NCD should not remain unchanged. Most respondents favored more flexibility in operator requirements, with many supporting either two operators of any combination or even a single operator. A majority wanted registry reporting to continue, but nearly 60% said CED should no longer be required for new indications. On heart team consultation, most supported keeping it, though with flexibility such as telehealth.<br /><br />During discussion, members emphasized several themes: flexibility, preserving the registry for quality oversight, and improving access while maintaining safety. Some argued that surgeon involvement should not be mandated, while others warned that removing the heart team could harm collaboration and patient care. Questions also addressed reimbursement, implementation timelines, and how new requirements might affect program expansion.<br /><br />SKy leadership concluded that it will wait for CMS’s draft decision memo, continue coordinating with other societies, and then submit comments that reflect member input. Members will also be offered template letters to send their own comments directly to CMS.

Asset Caption

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Keywords

TAVR

aortic

TAVI

CMS reconsideration

national coverage decision

coverage with evidence development

heart team consultation

operator requirements

registry reporting

aortic stenosis

member survey

health policy