UC San Diego Center for Transplantation "VAD Destination Therapy" Approved

The Joint Commission (TJC) has approved UC San Diego Health System’s Disease-Specific Care (DSC) Certification for Ventricular Assist Device (VAD). Hospitals performing VAD as a "destination therapy" (for permanent use) receive a certification of distinction and receive reimbursement from Centers for Medicare and Medicaid Services (CMS).

"The surveyors were extremely impressed with the level of integration and communication among all departments and at all levels as they interacted with staff at Sulpizio Cardiovascular Center and Thornton Hospital," said Alexander Aussi, BSN, RN, MBA, director, UCSD Center for Transplantation. "This is another proud moment for us our VAD team as well as the Health System."

Destination therapy provides permanent mechanical cardiac support for patients who have chronic end-stage heart failure. The cost of the VADs used for destination therapy is covered only if they have received approval from the FDA for that purpose.

"This certification ushers in an automatic approval by Medicare to support patients who are in need of long-term heart assistance and who do not qualify for a heart transplant," said Aussi. "In addition to the complement of services provided by the newly opened Sulpizio Cardiovascular Center (SCVC) for medical and surgical heart care, the Mechanical Assist Devices program - led by Jack Copeland, MD and Eric Adler, MD - utilizes an arsenal of devices that Copeland invented as bridge to transplant and destination therapy."

"Our team has been working toward this approval for more than one year. It is a landmark in our end-stage heart disease program and there is more to come," said Jack Copeland, MD, professor of surgery and director of cardiac transplantation and mechanical circulatory support at UC San Diego Health System.

In recent years, Medicare has issued several national coverage determinations providing coverage for services and procedures of a complex nature, with the stipulation that the facilities providing these services meet certain criteria. These criteria usually require, in part, that the facilities meet the minimum standards to ensure the safety of patients receiving these services in order to be considered as a provider with the ability and expertise to perform the procedure. An institution must be certified as a Medicare approved facility in order to perform procedures such as carotid artery stenting, bariatric surgery, certain oncologic PET scans in Medicare-specified studies, lung volume reduction surgery, and VAD destination therapy. Fewer than 110 facilities are approved for VAD destination therapy ( https://www.cms.gov/MedicareApprovedFacilitie/VAD/list.asp#TopOfPage ). UC San Diego Health System is one of only two San Diego-based systems and eight California-based systems offering this option.

"Medical assist devices and destination therapy bring new life to our patients who have few options and might not otherwise survive," said Michael Madani, MD, acting chief of cardiothoracic surgery and co-director of UC San Diego Sulpizio Cardiovascular Center. "Symptoms diminish, health improves, and our patients can then return to a near-normal quality of life."