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Medicare Wants to Wipe Out CCTA

by Barbara Kram, Editor | January 15, 2008
The Centers for
Medicare and
Medicaid Services
The commentary period has just closed on the December 13, 2007 Centers for Medicare and Medicaid Services (CMS) proposal on CCTA. The proposal is for a national coverage decision (NCD) with coverage with evidence development (CED) for cardiac computed tomography angiography (CCTA). The CMS proposal would effectively eliminate Medicare coverage for CCTA, according to the Society of Cardiovascular CT.

Medicare's stated purpose in requiring CED is to generate data on the utilization and impact of an item or service evaluated in the NCD, so that Medicare can: a) document the appropriateness of use of that item or service in Medicare beneficiaries under current coverage; b) consider future changes in coverage for the item or service; c) generate clinical information that will improve the evidence base on which providers base their recommendations to Medicare beneficiaries regarding the item or service.

As proposed, the NCD with CED would only allow Medicare coverage of CCTA for the diagnosis of coronary artery disease (CAD) if the Medicare beneficiary is enrolled in a clinical study approved by Medicare for:
-symptomatic patients with chronic stable angina at intermediate risk of CAD;
-or symptomatic patients with unstable angina at low risk of short-term death and intermediate risk of CAD.

The Society of Cardiovascular CT organized a recent advocacy effort regarding this issue. Toshiba America Medical Systems has joined the effort.