Health Policy Affairs

On Nov. 7, 2025, SIR, together with the Outpatient Endovascular and Interventional Society (OEIS), American College of Cardiology (ACC), Association of Black Cardiologists (ABC), Society for Cardiovascular Angiography and Interventions (SCAI), and Society for Vascular Surgery (SVS), submitted joint comments to Palmetto GBA on the proposed local coverage determination (LCD), “Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities” (DL40228). We commend Palmetto GBA’s commitment to improving patient outcomes and urge revisions to ensure the policy aligns with current national clinical guidelines and the statutory “reasonable and necessary” standard. Specifically, the societies request removal of rigid treatment timelines and mandatory accreditation requirements, clarification of coverage for acute and critical limb ischemia, and preservation of physician discretion in treatment decisions. These changes are essential to maintain patient access to timely, evidence-based, and cost-effective vascular care.