Informal Blog: CMS Hopes NCD on Treatment Resistant Depression

CMS has gone through multiple cycles of review, for many years, on whether it would pay for vagus nerve stimulation for treatment resistant depression (TRD).  It doesn't pay.   

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On May 30, CMS opened the NCD for review yet another time:

https://www.cms.gov/medicare-coverage-database/details/nca-tracking-sheet.aspx?NCAId=292&bc=gIAAAAAAQAAA&

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The review is based on a request from Liva Nova (formerly Cyberonics):

https://www.cms.gov/Medicare/Coverage/DeterminationProcess/downloads/id292.pdf   [14 pages]

Liva Nova issued a press release acknowledging the event, which was based on the November 2017 request letter linked above.

https://www.businesswire.com/news/home/20180530006514/en/LivaNova-Comments-U.S.-Centers-Medicare-Medicaid-Services%E2%80%99

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In June 2018, there have been a few trade journal articles on the topic:

https://www.medscape.com/viewarticle/898309

https://www.mddionline.com/will-cms-reverse-its-stance-livanovas-vns-depression

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Of note, the case went to a Departmental Appeals Board decision in 2014, which uphold the NCD as it stood,  The judges' decision is a remarkable 96 pages long:

https://www.hhs.gov/sites/default/files/static/dab/decisions/board-decisions/2014/dab2613.pdf

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Although Medicare doesn't cover VNS for TRD, it does cover the Myriad/AssureX pharmacogenetic test GeneSight for TRD:
https://med.noridianmedicare.com/documents/10546/6990983/MolDX+GeneSight+Assay+for+Refractory+Depression+LCD/9ffca6d1-637d-474a-8226-62c84c303731