Mandating chaperones for decision making in left atrial appendage occlusion is bad for patients, for physicians, and for the promotion of real shared decision making: It's time to end the Centers For Medicare Medicaid Services chaperone mandate.

The authors discuss research conducted by D. H. Howard and colleagues which focused on left atrial appendage occlusion (LAAO) shared decision making practices, published within the issue. Topics explored include the U.S. Centers for Medicare and Medicaid Services (CMS) coverage policy for LAAO, the response of physicians to the CMS chaperoned decision making mandate, and the patient-centered culture that need to be considered by the CMS.