What are the criteria from CMS for using continuous inotropic therapy?

The criteria from the Centers for Medicare & Medicaid Services (CMS) for using continuous inotropic therapy primarily focus on patients with a diagnosis of heart failure who exhibit depressed cardiac function. This distinction is crucial, as inotropic agents are typically utilized to improve contractility and cardiac output in individuals with heart failure, particularly when more conventional treatments are insufficient.

Inotropic therapy is often indicated for patients who demonstrate significant symptoms and functional limitations due to heart failure, making it essential that the patient has a documented heart failure diagnosis. Additionally, measuring cardiac function is a key component; depressed cardiac function, often assessed through left ventricular ejection fraction (LVEF), indicates a compromised ability of the heart to pump effectively, thereby justifying the need for inotropic support. This therapy aims to stabilize the patient’s condition and improve their quality of life, especially when other management strategies have failed.

In contrast, while stable cardiac function with minimal symptoms may not necessitate such intensive treatment, advanced frailty without a heart failure diagnosis would not qualify a patient for inotropic therapy. Similarly, a history of heart failure without effective medication management alone does not meet the criterion for continuous inotropic therapy without the pressing need established through current symptoms and cardiac dysfunction.