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AHP SettlementMatrix B-1

Matrix B-1 - For Diet Drug Recipients

Diet Drug Recipients who are eligible for matrix payments and to whom one or more of the following conditions apply, receive payments on Matrix B-1:

1. Diet Drug Recipients who ingested Pondimin and/or Redux for 60 days or less, who were diagnosed as FDA Positive.
2. Diet Drug Recipients who ingested Pondimin and/or Redux for 61 or more days, who were diagnosed as FDA Positive with any of the following conditions:

With respect to an aortic valve claim:

1. The following congenital aortic valve abnormalities: unicuspid, bicuspid or quadricuspid valves, ventricular septal defect associated with aortic regurgitation;
2. Aortic dissection involving the aortic root and/or aortic valve;
3. Aortic sclerosis in people who are > 60 years old as of the time they are first diagnosed as FDA Positive; Aortic root dilatation >5.0 cm;
4. Aortic stenosis with an aortic valve area <1.0 square centimeter by the Continuity Equation.

With respect to a mitral valve claim:

1. The following congenital mitral valve abnormalities: parachute valve, cleft of the mitral valve associated with atrial septal defect;
2. Mitral Valve Prolapse as determined by Echocardiogram. "Mitral Valve Prolapse" refers to a condition where (a) the echoardiogram video tape or disk includes the parasternal long axis view and (b) that echocardiographic view shows displacement of one or both mitral leaflets >2mm above the atrial-ventricular border during systole, and >5mm leaflet thickening during diastole, as determined by a Board-Certified Cardiologist.
3. Chordae tendineae rupture or papillary muscle rupture; or acute myocardial infarction associated with acute mitral regurgitation;
4. Mitral annular calcification;
5. M-Mode and 2-D Echocardiographic evidence of rheumatic mitral valves (doming of the anterior leaflet and/or anterior motion of the posterior leaflet and/or commissural fusion), except where there is no evidence of rheumatic valve disease upon pathological examination of mitral valve tissue.

With respect to claims for the aortic and/or mitral valve(s):

1. Heart valve surgery prior to Pondimin and/or Redux use on the valve that is the basis of claim;
2. Bacterial endocarditis prior to Pondimin and/or Redux use;
3. FDA Positive regurgitation (confirmed by Echocardiogram) prior to Pondimin and/or Redux use for the valve that is the basis of claim;
4. Systemic Lupus Erythernatosus or Rheumatoid Arthritis¹ and valvular regurgitation and/or valvular abnormalities of a type associated with those conditions² ;
5. Carcinoid tumor of a type associated with aortic and/or mitral valve lesions;
6. History of daily use of methysergide or ergotamines for a continuous period of longer than 120 days.

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