Wednesday, November 9, 2022

MolDx CAC on Transplant Tests: Noridian versus MolDx Wording

 

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

https://palmettogba.com/palmetto/jmb.nsf/DIDC/VN8Y8XLZGA~Medical%20Policies~LCD%20Development%20Meetings

Photo.