Might this reflect partially on one of the reasons the US ranks at the bottom for preventative health care...BD
January 14, 2008 (Washington, DC) - Proponents of cardiac CT angiography (CTA) are, in the words of one clinician, "in uproar and panic" over a proposed national coverage determination (NCD) by the US Centers for Medicare & Medicaid Services (CMS). Far from establishing national Medicare coverage for patients undergoing CTA--something that all 50 individual states already provide under local coverage determinations--the federal policy decision would limit Medicare coverage of a diagnostic CT to just two indications and only in cases where the patient was enrolled in a clinical trial of cardiac CT.
"But unfortunately this time, they've added another acronym, CED--coverage with evidence development--which is a totally different ball of wax. What it means is CTA will be covered only if the patient is enrolled in some kind of clinical trial."
"We really didn't think they'd go through with this, so that's why everybody was shocked when they came out a few weeks back and said that they are ready to implement this. If you read it, it already sounds like a final decision. It's open for discussion, but the chance that they'll actually revoke it is pretty slim."
Zadeh notes that, in the past, the CMS has rarely gone back and rejiggered a proposed or finalized NCD for cardiac imaging, even after evidence supporting a benefit of the technology on hard outcomes is in. "A similar thing happened with PET scanning, which has never really gotten reimbursement," he told heartwire.
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