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The Centers for Medicare and Medicaid Services (CMS) will now cover 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 prothrombin levels (also called INR testing) in the home 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 in a release. "The decision reflects our commitment to expanding Medicare coverage to include effective preventive care and services."
Noted 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 existing 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 to be 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.