As I noted in a November 2 blog, in mid-November the Noridian and Palmetto MACs will hold a joint public advisory meeting on their LCDs for circulating-DNA-based kidney and liver graft rejection. Original post here.
There are some subtle differences between the Noridian
announcement of the agenda, and the Palmetto MolDx one.
|
Noridian |
MolDx |
|
The Centers for
Medicare and Medicaid Services (CMS) assigned Noridian Healthcare Solutions,
Jurisdiction E and Jurisdiction F the task of developing Local Coverage
Determinations (LCDs). Noridian requested
an internal reconsideration of the Molecular Diagnostic Testing for Acute
Rejection LCD after noting unexpected utilization patterns that are outside
of expectations based on evidentiary review and manufacturer documentation. The A/B MACs
participating in the MolDX Program seek to learn from the experts’ analysis
of the selected literature regarding the clinical utility of molecular
diagnostic testing for acute rejection. The SME discussion may inform proposed revision(s) to
relevant policy (LCD) as part of a contractor-initiated internal
reconsideration. |
Noridian Healthcare
Solutions along with Palmetto GBA will host a Multi-Jurisdictional Contractor
Advisory Committee (CAC) Meeting via teleconference on November 16, 2022,
from 2–4 p.m. CT. Discussions will focus on Molecular Diagnostic Testing for
Acute Rejection in Kidney or Liver Allografts. |
|
The purpose of the CAC
meeting is to provide a formal mechanism for healthcare professionals to be
informed of the evidence used in developing the LCD and promote
communications between the MAC and the healthcare community. For this CAC,
invited Subject Matter Experts (SMEs) are asked to examine
and discuss selected published articles related to Molecular
Diagnostic Testing for Acute Rejection in Heart, Lung, Kidney and Liver
Allografts and rate their level of confidence in the literature by responding
to a series of Key Questions. During the CAC
meeting, discussions between the invited SMEs and contractor (CMD)
facilitator(s) will be recorded. Any stakeholders and the general public are
invited to register for this meeting and listen to these discussions
in real-time; or they may also listen to a recording of the meeting and
access a transcript of the discussion posted to the contractors’ website
following the event. |
The Centers for
Medicare and Medicaid Services (CMS) assigned Medicare Administrative
Contractors (MACs) the task of developing Local Coverage Determinations
(LCDs). The purpose of the CAC
meeting is to provide a formal mechanism for healthcare professionals to be
informed of the evidence used in developing the LCD and promote
communications between the MAC and the healthcare community. The CAC panel will be
asked to discuss the clinical literature related to Molecular
Diagnostic Testing for Acute Rejection in Kidney or Liver Allografts and rate
their confidence in a series of Key Questions. Discussions will occur
between CAC panelists and Contractor Medical Directors. The public may
attend; however, questions from the public will not be entertained. Interested
stakeholders are invited to listen via teleconference; however, advance
registration is required. Registration is available at CVENT Kidney or Liver
Allografts. Once registered you
will receive the teleconference information via email prior to the meeting.
Lines will remain muted throughout the conference except for the invited CAC
panelists and the MAC hosts. |
I don’t know what the “unexpected utilization
patterns” are, but my memory is the LCDs in this space are pretty vague about
specific indications or rules or frequency for medical necessity, and that
vagueness may be raising issues.
Noridian
https://web.cvent.com/event/3fe72b43-dc24-4090-9b8b-fdf67af7713e/summary
Palmetto
