The Centers for Medicare and Medicaid Services announced on Wednesday their decision to maintain coverage of cardiac and coronary CTA (CCTA) through the Local Coverage Determination process, and they opted not to adopt a National Coverage Determination.
In June 2007, CMS had initially proposed to begin a National Coverage Analysis that would have effectively limited Medicare coverage for CCTA to select clinical studies that met specific, tight restrictions. All other uses of cardiac CTA for the diagnosis of CAD would not be covered for Medicare beneficiaries.
Several societies, including the American College of Radiology, responded with their strong opposition to the proposal. They published a joint release in January that pointed to the limited validity of the evidence on which CMS based their draft policies and drew attention to newer research and data that demonstrated CCTA’s importance. U.S. lawmakers, from both the Senate and the House of Representatives, joined in the effort, sending CMS letters that urged them to reconsider the proposed NCD with coverage with evidence development.
Medicare local coverage determination policies in all 50 states and the District of Columbia support coverage of CCTA. Aetna, Humana, UnitedHealth Group and 14 Blue Cross Blue Shield carriers also provide coverage of the non-invasive procedures.
