A coalition of leading medical societies, including the American College of Radiology (ACR), have issued recommendations to the Medicare Evidence Development Coverage Advisory Committee (MEDCAC) calling for continued research into treatment and clinical management of peripheral arterial disease. The recommendations were recently published online in the Journal of the American College of Radiology.
The governmental panel, which advises CMS about how it may use existing evidence to justify future determinations about Medicare coverage, recently examined the scientific evidence behind existing peripheral arterial disease interventions and addressed areas where evidence gaps exist.
Specific recommendations laid out by the coalition in response to MEDCAC include:
- Proven therapies, such as supervised exercise therapy, should be offered to all Medicare patients with intermittent claudication (painful cramping in the leg or hip that occurs when walking or exercising and typically disappears when an individual stops the activity).
- Revascularization (redirecting blood flow via endovascular or surgical treatment) is appropriate for patients who have intermittent claudication that is lifestyle-limiting despite a non-invasive treatment approach.
- Revascularization for patients with critical limb ischemia (CLI) should be encouraged and reimbursed according to quality of care and outcomes literature. The groups endorse the development of CLI teams for optimal care.
- Systematic collection of reliable data regarding management of all patients with PAD will enhance the understanding of outcomes and help define appropriate care for the future.
“Identifying quality health care and impacting the treatment of a disease that affects millions of Americans are critical,” said Anne Roberts, MD, ACR vice president and co-author of the response to the MEDCAC panel. “The coalition believes that disparities in amputation, revascularization and access to PAD medical care should be recognized and eliminated.”