New York Uses AHRQ Research to Change Medicaid Coverage for Coronary Artery Disease Tests
In 2006, the New York State Department of Health (DoH) decided against covering non-invasive imaging tests for coronary artery disease (CAD) under the State's Medicaid program. This decision was based in part on evidence presented in the AHRQ Technology Assessment, Non-Invasive Imaging for Coronary Artery Disease.
According to James J. Figge, MD, Medical Director, Office of Health Insurance Programs in the DoH, State officials reached this decision "primarily because the AHRQ report showed that conclusive evidence regarding efficacy [of these tests] was lacking at this time." Figge indicated that the State will likely revisit this decision annually.
The two non-invasive imaging tests examined in detail in the evidence report are computed tomographic angiography and magnetic resonance angiography for evaluating native (non-grafted) coronary arteries.
New York officials reported on their use of the AHRQ technology assessment during an evidence review audio conference with the Medicaid Medical Directors' Learning Network, which focused on non-invasive imaging for CAD. Approximately 15 of the 35 State Medicaid Medical Directors who are represented in the Learning Network participated in the call.
Medicaid spending in New York State totaled $44.7 billion in FY 2006, the largest for any state, and accounted for 14.7 percent of total Medicaid spending for the U.S., according to data from the Kaiser Family Foundation. With 4.9 million Medicaid beneficiaries in FY 2004, New York had the second highest Medicaid enrollment, after California.
The AHRQ technology assessment was prepared by the Evidence-Based Practice Center at Duke University to provide background information to the Medicare Coverage Advisory Committee.
Non-Invasive Imaging for Coronary Artery Disease, Technology Assessment, October 2006, Agency for Healthcare Research and Quality, Rockville, MD. Contract No. 290-02-0025. http://www.cms.hhs.gov/determinationprocess/downloads/id34TA.pdf [PDF File, 246 KB].