ACR Supports CMS Decision Not to Limit Coverage for CCTA
The American College of Radiology supports the Centers for Medicare and Medicaid Services’ (CMS) decision to continue coverage of Cardiac and Coronary CTA (CCTA) through the Local Coverage Determination process and create no National Coverage Determination for these important non-invasive imaging procedures.
Since CMS's initial proposal in June 2007 to begin a National Coverage Analysis that might limit CTA coverage to tightly restricted instances where CTA was performed as part of an ongoing clinical study, the ACR, as part of a multi-society effort, has worked to educate CMS regarding the limited validity of the evidence on which they based their draft policy and the greater importance of the newer research and data which they had not fully considered.
The ACR organized several meetings and conference calls with CMS officials, and together with other specialty societies, contributed updated research and guidance which supported the continued coverage of CCTA under currently defined local Medicare policies. Without the combined strengths of the ACR and the multi-societal groups, CMS’ final decision may have been very different.
The efforts of the ACR, its economics leadership, and cardiac imaging clinical experts strongly opposing the draft proposal played an enormous role in helping CMS make an informed final decision.
Currently, Medicare local coverage determination policies in all 50 states and the District of Columbia support coverage of CCTA. Coverage is also provided by Aetna, Humana, UnitedHealth Group and 14 Blue Cross Blue Shield carriers.
As this technology advances, the ACR will continue to establish further appropriateness criteria guidelines and encourage further research development and data collection.
Click here to read the CMS Decision summary regarding CCTA.
