Heart Scans Still Covered by Medicare

Heart Scans Still Covered by Medicare

The federal government said it would continue to cover the use of an increasingly popular procedure to detect heart disease. The Centers for Medicare and Medicaid Services said it would continue to cover the scanning procedure, despite its earlier misgivings over whether there was enough evidence to justify paying for the tests under Medicare. The agency said that it would continue to leave payments for the scans up to the local insurance carriers it employs to oversee medical claims. Most local carriers have been covering the test, a form of CT scan that can cost $600 or more.

Medicare paid for roughly 70,000 of the heart scans in 2006, according to the agency, at a cost of $40 million to $50 million. For people not yet eligible for Medicare, thousands of other such scans were paid for by commercial insurers or from patients’ own pockets, at prices sometimes close to $1,000. As many as 1,500 centers around the country are estimated to be offering the scans, with some centers advertising their services.

The scans are now widely promoted as a noninvasive alternative to tests like angiography, which requires the insertion of a catheter into the blood vessels and can cost thousands of dollars. But conventional angiography is typically done only on patients with cardiac symptoms. There is growing concern that the CT scans are being done increasingly on those who show no signs of heart disease, subjecting them needlessly to radiation risks.

In December, the Centers for Medicare and Medicaid Services had said it would not pay for the scans unless patients were enrolled in a study to test the technology’s effectiveness. The proposal to curtail payments met with fierce resistance from doctors who perform these scans and companies that make the equipment. But the Centers for Medicare and Medicaid Services said there remained “uncertainty regarding any potential health benefits” from the scans and described the existing evidence as of “overall limited quality and limited applicability.”

Source: www.nytimes