The past few months have generated spirited discussion about the future of Transcatheter Aortic Valve Replacement (TAVR) and the potential changes to requirements that govern programs across the United States. Throughout this process, SCAI has been advocating on behalf of the interventional cardiology community. 

The ongoing Centers for Medicare & Medicaid Services (CMS) review of the TAVR National Coverage Determination (NCD) could shape future policy related to patient access, Heart Team requirements, quality oversight, and program standards. Alongside recent media coverage, these issues have taken on added importance. CMS is soon expected to release a Proposed Decision Memo, opening a new public comment period and providing another crucial opportunity to make our voices heard. 

As the professional society representing interventional cardiologists, SCAI has gathered feedback from our members, responded to public discussion, and hosted a June 2 Virtual Town Hall to help inform our next steps. 

Listening to Members: Survey and Virtual Town Hall 

As CMS prepares to release its Proposed Decision Memo, SCAI has focused on gathering feedback directly from members and the interventional cardiology community. 

Following the SCAI 2026 Scientific Sessions in April, more than 100 interventional cardiologists participated in a grassroots effort focused on the ongoing TAVR NCD review and the need for policies that reflect contemporary practice. 

To further inform SCAI's advocacy efforts, the Society launched a member survey that generated 267 responses. The survey revealed broad support for modernizing the current NCD framework while preserving core elements that members believe are essential to quality patient care:

• 76% said the current TAVR NCD should change

• 85% supported requiring Heart Team consultation in some form

• 68% supported maintaining registry reporting requirements

• 59% opposed continuing Coverage with Evidence Development (CED) requirements for new indications

• 41% supported maintaining a two-operator requirement with greater flexibility in who those operators can be

• 38% supported allowing a single-operator option

On June 2, SCAI hosted a public, virtual town hall to discuss the ongoing CMS review and hear direct feedback (watch online). The discussion focused on informing SCAI's comments to CMS ahead of the upcoming public comment period. 

Participants expressed broad support for: 

• Preserving the Heart Team model as a cornerstone of patient care

• Maintaining quality oversight through continued outcome tracking and registry participation

• Providing greater flexibility in operator and program requirements while maintaining high standards of care

• Protecting patient access to TAVR

• Ensuring that future requirements are aligned with contemporary practice and the best available evidence

Together, our findings reflect a desire for greater flexibility within the current framework while preserving key quality and oversight measures. 

Responding to Recent Public Discussion  

In response to articles in the media, particularly in The Wall Street Journal, SCAI joined with the American College of Cardiology (ACC) and The Society of Thoracic Surgeons (STS) in issuing a joint statement reaffirming the importance of Heart Team-based care and patient-centered decision-making. 

SCAI also joined ACC in submitting a letter to the editor of The Wall Street Journal. Although the letter was not published, it emphasized several key points: 

• The coverage did not fully reflect the central role of the multidisciplinary Heart Team in determining the most appropriate treatment for each individual patient. 

• Treatment decisions should be individualized for each patient. 

• Patients should be evaluated by a multidisciplinary Heart Team. 

• TAVR and Surgical Aortic Valve Replacement (SAVR) are both important treatment options supported by extensive clinical evidence. 

• Clinical decisions should be guided by evidence, experience, and patient-specific factors. 

• The goal is not to favor one therapy over another, but to match each patient with the treatment best suited to their individual needs. 

SCAI's Position and Next Steps 

Several principles have consistently emerged from SCAI's engagement: 

• Preserve the Heart Team model

• Support evidence-based, patient-centered decision-making

• Maintain quality oversight through robust outcomes reporting

• Promote patient access to structural heart therapies

• Ensure that policy reflects contemporary practice and real-world experience

Once CMS releases the Proposed Decision Memo, a new public comment period will begin. SCAI will carefully review the proposal and develop comments informed by the member survey responses, the town hall discussion, ongoing engagement, and the best available evidence. We will also provide resources to help members participate directly in the comment process. 

As we noted during the town hall, SCAI's role is not simply to submit comments on behalf of the Society. Our responsibility is to represent the collective expertise and experience of our members and ensure that their voices are heard throughout the policymaking process. 

Thank you to everyone who contributed their perspectives so far. Your engagement is helping shape SCAI's response and ensuring that the interventional cardiology community has a strong voice in this important discussion. 

If you have any further feedback or comments, please reach out on MySCAI or email [email protected].

J. Dawn Abbott, MD, MSCAI
2026–27 SCAI President