Administrative Memos

200409

FROM: Theodore O. Will, Chief Executive Officer
DATE: Nov 15, 2004
SUBJECT: IPRO IMPLANTABLE CARDIOVERTER DEFIBRILLATOR SPECIAL PROJECT UPDATE
IPRO CONTACTS:

Kathy Terry, Ph.D., Senior Director, Medicare/Federal Health Care Assessment, Ext. 226

The purpose of this memorandum is to provide an update on recent developments regarding IPRO's Implantable Cardioverter Defibrillator (ICD) Project. In August 2004, IPRO distributed Medicare Administrative Memorandum #2004-05/HPMP Administrative Memorandum #2004-06, Automatic Implantable Cardioverter Defibrillator (AICD) Project Baseline Report. This memorandum provided baseline reports along with a project CD-ROM containing an Access-based ICD screening tool and educational materials. The information was also distributed to Electrophysiologists throughout the State.

In September, IPRO conducted two "Webinar" Trainings: one to review the baseline results of the study and address areas for improvement using case examples; and the other to provide hospital staff with training in the use of the ICD screening tool. IPRO also created an ICD Website (www.ipro.org/hpmp), to provide physicians and hospitals with access to all project information, including the CD contents. Both "Webinar" conferences were recorded and posted on the Website. The ICD Project was also posted on the JENY (Joint Effort New York) website http://jeny.ipro.org which allows for easy access to project updates and downloads, permits comments from the community on information posted, and, facilitates comprehensive, real-time information exchange.

Subsequent to the above intervention activities, the Centers for Medicare and Medicaid Services (CMS) issued a Draft Decision Memorandum on September 28, 2004 outlining their consideration of additional clinical indications for ICD insertion. In response to the many questions we received about this CMS Decision Memorandum, IPRO posted a reply on the JENY Website that highlighted key elements to assist physicians and providers in gaining an understanding of the proposed guideline changes and their implications on clinical practice. A copy of the information as it appears on the website is included as Attachment I. Upon release of CMS' final (revised) National Coverage Guidelines, the IPRO ICD team will revise the data collection prescreen tool to include the changes. IPRO intends to provide hospitals and physicians with this tool via our JENY website. We will also provide training on the use of the new data collection tool. Until then, the tool currently available on the JENY Website remains applicable and should be used ¹.

In addition, an "Implant Checklist" is included as Attachment II to this Memorandum. The checklist may be used as a quick reference guide, to further assist physicians and hospitals in ensuring appropriate clinical indications are met, according to the current Medicare Coverage Guidelines. This checklist will also be revised and redistributed upon final issuance of the revised CMS Coverage Determinations.

In the interim, should you have any questions regarding this project please contact Dr. Kathy Terry at 516-326-7767, extension 226. You may also post any questions or concerns that may be of interest to the ICD community at large to http://jeny.ipro.org.

¹ Note: Shortly after the CDs were distributed, as part of our continuous effort at providing Quality Assurance, IPRO discovered a small programming glitch in the computerized ICD screening tool. The tool was revised and the updated version containing all currently approved algorithms was posted on JENY.