Commentary: Medicare Coverage Advisory Committee meeting on noninvasive imaging for coronary artery disease

The MCAC is advisory in nature, with the final decision on all issues resting with the CMS. Since its inception the MCAC has considered >20 topics as diverse as treatments for age-related macular degeneration, bariatric surgery for morbid obesity, and compendia listings for off-label uses of drugs and biologics in anticancer treatment. The panel expressed no level of confidence that either 16-slice or 64-slice CTA provides incremental benefit when used after x-ray angiography, that the diagnostic test characteristics of either can be generalizable to the Medicare beneficiary population, or that either provide a net health benefit to Medicare beneficiaries compared with invasive imaging strategies.