CMS Announces LCD to Remain in Place for CCTAThe Centers for Medicare and Medicaid Services (CMS) announced late this afternoon (March 12, 2008) that the local coverage determination process (LCD) will be left in place for CCTA. No national coverage determination (NCD) will be adopted at this time.This is exactly what SCCT requested! Our SCCT leaders and members worked hard to submit comments, meet with CMS, and provide the agency with needed information. SCCT leaders, members, and advocacy consultants worked as a team to bring this issue to the attention of Congress. 79 Members of the House of Representatives ultimately signed a letter to CMS to express concern about the proposed NCD. In addition, almost a dozen U.S. Senators wrote to CMS with their concerns. This is a direct result of our active grassroots involvement! Click here to read the memo.
79 Members of the U.S. House of Representatives Relay Their Concerns to Medicare About the Proposed NCD for CCTAOn March 7, 2008, 79 Members of the U.S. House of Representatives sent a letter to the Centers for Medicare & Medicaid Services (CMS) urging them to reconsider the proposed national coverage determination (NCD) with coverage with evidence development (CED) for cardiac computed tomography (CCTA). The overwhelming support comes after many SCCT members diligently contacted their representative asking for his signature. Additionally, at least one dozen U.S. Senators sent individual letters to CMS expressing their concerns about the proposed coverage determination.Click here to read the letter.
SCCT Action Alert Encourages You to Write to Congress Regarding CMS NCDThe SCCT Board of Directors believes this important issue must be brought to the attention of Congress. On January 18, a SCCT Action Alert was emailed to members requesting all to contact your U.S. Representative and both of your Senators. Talking points were included for you to include in your email to Congress. Instructions were also included on how to easily contact Congress. We need Congress to recognize that the coverage decision would harm Medicare beneficiaries by restricting access to this important diagnostic tool. Click here for the Action Alert.
Multi-society Comment Letter Submitted to CMSA letter was submitted jointly by the Society of Cardiovascular Computed Tomography, American College of Cardiology, American College of Radiology, American Society of Nuclear Cardiology, North American Society of Cardiovascular Imaging, and Society for Cardiovascular Angiography and Interventions to CMS commenting on the NCD proposal. Click here to read the entire letter.
CMS Proposal Would Effectively Eliminate Medicare Coverage for CCTA — Comment by 1/12/2008On December 13, 2007, the Centers for Medicare and Medicaid Services (CMS) released a proposed national coverage decision (NCD) with coverage with evidence development (CED) for cardiac computed tomography angiography (CCTA). 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:
All other uses of cardiac CTA for the diagnosis of CAD would be non-covered for Medicare beneficiaries. Please act now. To learn more, click here.
Consensus Update on the Appropriate Usage of Cardiac Computed Tomographic AngiographyThe consensus statement outlined here was formulated following a roundtable meeting among clinical experts in the fields of radiology and cardiology held in Miami, Florida, in June 2007. This group was gathered under the auspices of two key specialty societies supporting the field of computed tomographic angiography (CTA): the Society of Cardiovascular Computed Tomography (SCCT) and the North American Society for Cardiac Imaging (NASCI).To view the entire document, click here.
CMS Releases Proposed NCD for Cardiac CTAOn December 13, 2007, the Centers for Medicare and Medicaid Services (CMS) released a proposed NCD for Cardiac CTA (CCTA) with Coverage with Evidence Development (CED). The purpose of 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. The proposed NCD is the result of the earlier national coverage analysis (NCA) issued by CMS this past June. To learn more, click here.To view the proposed decision, click here.
CMS Releases 2008 Final RulesThe final 2008 Medicare Physician Fee Schedule rule and Hospital Outpatient Prospective Payment System (HOPPS) rule were released last week spelling out more cuts for cardiology and radiology in terms of diagnostic imaging, specifically cardiovascular computed tomography. While the final HOPPS rule for the most part does not impact physician payment, it does affect the resources available to support services performed by physicians in the hospital outpatient setting. To learn more, click here.
CMS Releases Stark IIIOn September 5, the Centers for Medicare & Medicaid Services (CMS) published its long-anticipated final rule outlining the third phase of regulations prohibiting physician self-referral. These regulations commonly called the Stark Law after US Representative Pete Stark (D-California), who sponsored the initial bill bar physicians from referring Medicare patients for services, tests or equipment provided by organizations in which the physicians or their family members have a financial interest. Significant new Stark Phase III provisions redefine arrangements between hospitals and individual members of group medical practices as direct rather than indirect compensation; eliminate the safe harbor methodology for calculating fair market value for hourly physician services; and create additional flexibility for rural hospitals in recruiting and retaining physicians. This rule makes no changes to the in-office ancillary services exemption, but cites this area as a possible target for future rulemaking. CMS emphasizes that the provisions of Stark Phase III, which will take effect December 4, are intended to coordinate with andnot supersede provisions of CMS coverage and payment rules. Phase III language also emphasizes that all 3 phases of Stark regulations must be read and understood as a whole. This is the final rule, not interim final with comment and will be effective 90 days after publication.
SCCT Comments on Proposed Medicare Fee ScheduleSCCT provided comments to CMS on the proposed 2008 Medicare Physician Fee Schedule. SCCT commented on concerns addressing the newly proposed standards for independent diagnostic testing facilities, new physician self-referral provisions and diagnostic imaging equipment usage percentage assumptions. SCCT also urged CMS to work with Congress to avert the proposed 10% cut for 2008 and ensure that physician payment updates for 2008 and subsequent years accurately reflect increases in medical practice costs. The final rule should be released at the end of November or beginning of December. To view the proposed, click here.
SCCT Continues Lobbying Efforts for Medicare ReformWith Congress back in session, SCCT plans to continue its efforts to prevent the 10 percent Medicare payment cuts as a result of the Sustainable Growth Rate. Coupled with additional policy changes proposed by CMS cardiology and radiology could see an overall cut of more than 15 percent in 2008-even greater depending on one's mix of services.
SCCT Comments on WA Health Technology AssessmentSCCT provided comments to the Washington Health Care Authority on its second round of technologies up for review. The HCA Administrator, in consultation with participating agencies, selected Cardiac Stent (Off label usage), Artificial Discs, Arthroscopic Surgery of the Knee, Computed Tomographic Angiography (CTA for cardiac care), Virtual Colonoscopy (CTC) and Intrathecal Pump (Chronic non-cancer pain management) as the second group of health technologies that will undergo a scientific review process this fall/winter. HCA is interested in issues of efficacy, safety and accuracy regarding use of CT Angiography imaging for screening of coronary artery disease. The state believes there is concern that CTA may not identify accurately those patients with chest pain who will need catheter-based or surgical revascularization. SCCT provided general comments on CCT to begin dialogue and offered its assistance and local Washington CCTA experts for further discussion. To learn more, use the following link: http://www.hta.hca.wa.gov/reviews/index.shtml
SCCT Comments on Proposed HOPPS RuleComments on the proposed 2008 Hospital Outpatient Prospective Payment System Rule (HOPPS) were submitted in September 2007. In the rule, CMS outlined a number of complex and far-reaching proposals, including bundling changes that warrant detailed review. CMS also proposed seven new categories and two "composite" categories, along with changes in APC assignment for cardiac computed tomography (CCT) and cardiac computed tomography angiography (CCTA). Societies commented on many issues, including disagreement with CMS' rationale for moving the CCT and CCTA codes simply due to its proposed bundling of diagnostic radiopharmaceuticals. To view the comments, click here.
SCCT Advocacy Briefing for July 2007To view the SCCT Advocacy Briefing for July 2007, please click here.
SCCT Comments on CMS' NCA for CTAIn response to the National Coverage Analysis (NCA) for Computer Tomographic Angiography (CTA) announced by the Center for Medicare and Medicaid Services (CMS) on June 15, SCCT submitted comments to address its concerns with the proposed NCA. SCCT focused its comments on keeping coverage at the local level, the proposed limited indications for CTA and the CMS' need for waiting level I clinical evidence to demonstrate improved patient health outcomes with CTA. To view the comments, click here.To view all NCA for CTA, click here.
July 2007 Advocacy UpdateClick here to view the presentation given by new SCCT President Michael Poon, MD at the 2nd Annual Scientific Meeting in Washington, DC. This presentation SCCT members are encouraged to contact their senators and representatives in an effort to stop payment cuts and protect imaging. Please act quickly, voting may begin as early as the week of July 9, 2007. To contact your members of Congress, please use toll-free grassroots hotline: 800-210-7193. (in collaboration with ACC, phoneline sponsored by ACC)
SCCT Advocacy Briefing for June 2007To view the SCCT Advocacy Briefing for June 2007, please click here.
Medicare CCTA Coverage MapTo view the complete Medicare CCTA Coverage Map as of May 2007, please click here.
Breaking News: UnitedHealthcare to Require Diagnostic Imaging AccreditationUnitedHealthcare (UHC) has announced that, beginning March 1, 2008, diagnostic imaging accreditation will be required as a condition for reimbursement for all contracted imaging facilities and physicians. UHC will work with by the American College of Radiology (ACR) and the more than 22 sponsoring organizations of the Intersocietal Accreditation Commission (IAC) to accredit the facilities and physicians.The UnitedHealth Imaging Accreditation Program? is requiring that all participating, freestanding imaging facilities and physician offices performing CT, CTA, MRI, MRA, Nuclear Medicine/Cardiology, PET, and Echocardiography become accredited. SCCT is working with the IAC to finalize its CT accreditation board which will be live in 2007 and will be recognized by UHC for accreditation under its new initiative. ACR has already released its revised CT accreditation program. To view the UHC Press Release, please click here. To view the Imaging Accreditation Brochure, please click here. To view the IAC Press Release, please click here. To view the UHC Letter to Practices, please click here.
Cardiac CTA Covered in All 50 StatesDecember 1, 2006 marked coverage in all 50 states by Medicare carriers. Medicare Administrative Contractor, Noridian Administrative Services (NAS) was the last to announce coverage in the form of a coverage article and is still working to finalize its LCD, which should be completed before February 2007. While some LCDs are more inclusive than others, the foundation for coverage of Cardiac CTA has been laid. The model Local Coverage Determination (LCD) for Cardiac Computed Tomography and Computed Tomography Coronary Angiography, which SCCT assisted in developing, released over a year ago played a vital role in guiding the Medicare carriers to create and modify their LCDs. SCCT continues to work on expanding limited LCDs with Medicare carriers and exploring coverage with private payers.To view the model LCD, click here. To view a complete list of your Medicare carrier's LCDs, go to http://www.cms.hhs.gov/mcd/index_lmrp_bystate.asp Currently only one carrier covers calcium scoring, California, National Heritage Insurance Company
Advocacy Committee ActivityA hearing was held on March 17, 2005 by Congresswoman Nancy L. Johnson [R-CT] Chairman, Subcommittee on Health of the Committee on Ways and Means, US House of Representatives , on managing the use of imaging services. After the hearing, the following written statement was submitted to Congresswoman Johnson by SCCT Past President, Stephan Achenbach, MD. Click here to download the statement.
AMA House of Delegates ResolutionSee the Imaging Resolution passed at the June 2005 Annual Meeting of the American Medical Association's House of Delegates. Click here.
Letter Sent to Senator Michael B. EnziSee a recent letter sent to the Chairman of the Health, Education, Labor and Pension Committee.
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