Advocacy Monthly: July 2018

MEDCAC Considers Volume Requirements for TAVR 
On July 25, a Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) panel heard recommendations regarding procedural volume requirements for hospitals and heart team members to begin and maintain transcatheter aortic valve replacement (TAVR) programs. Among the presenters were Joseph E. Bavaria, MD, David M. Shahian, MD, and Thoralf M. Sundt, MD. During the presentation, Dr. Bavaria stressed that programmatic TAVR volume requirements are essential: “Quality cannot be reliably determined at low-volume centers—good or bad. That is the conundrum.”

View presentation slides from the meeting:

Joseph E. Bavaria, MD

David M. Shahian, MD


The MEDCAC panel will now advise the Centers for Medicare & Medicaid Services as CMS prepares a new TAVR National Coverage Determination due for release next June. In addition, CMS will consider written comments, including those in a joint letter from STS, the American Association for Thoracic Surgery (AATS), the American College of Cardiology (ACC), and the Society for Cardiovascular Angiography and Interventions (SCAI).

New TAVR Expert Consensus Document Available
Prior to the MEDCAC meeting, the four societies published an expert consensus document on TAVR in each of their respective peer-reviewed journals, including The Annals of Thoracic Surgery. The writing committee for the “2018 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and Institutional Recommendations and Requirements for Transcatheter Aortic Valve Replacement” was co-chaired by Dr. Bavaria and Carl L. Tommaso, MD. The document updates a 2012 version and identifies criteria for performing TAVR procedures safely, while optimizing patient outcomes. A related editorial, “TAVR 2.0: Collaborating to Measure, Assure, and Advance Quality,” by Dr. Shahian and colleagues, also will be published in The Annals.

STS Signs Letters to FDA on Tobacco Regulation
The Society has joined two Campaign for Tobacco-Free Kids letters to the Food and Drug Administration (FDA) regarding tobacco regulation issues.

  • The first letter supports banning flavors, including menthol, in all combusted and smokeless tobacco products. The comments cite the FDA’s own materials showing that flavored products play a critical role in attracting new tobacco users (especially children) and increase the likelihood of long-term addiction.  
  • The second letter argues that premium cigars should be subject to FDA regulation.

Key Contact Connect
Meet Your Lawmakers at Home

Your legislators will be hitting the campaign trails at home this summer and fall. Take advantage of their proximity and schedule time to advocate for cardiothoracic surgery. Read about the different opportunities available to you, and then contact STS Government Relations Coordinator Madeleine Stirling to get the ball rolling.

Questions? Want to get involved in advocacy?
Contact the STS Government Relations office via email or at 202-787-1230.

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