Scope of CTAAB Review:
CTAAB will assess community need for health care projects in the areas of new or
expanded technology, new or expanded services, and major capital expenditures as
proposed by public providers (e.g., Article 28) and private providers (e.g.,
physicians, entrepreneurs, and health facilities). The CTAAB will make
determination on whether:
- An application of a new technology or service or novel application of an
existing technology or service represents appropriate evidence-based medical
practice;
- Additional health service capacity is warranted, taking into account
geographic location, access, cost-effectiveness, quality, and other community
issues.
For the purposes of determining the scope of CTAAB activities:
- A
service is defined as a program offered by a health care provider for which
public or third party reimbursement is sought.
Examples: ambulatory
surgical centers, sleep centers, women’s health centers, infusion therapy
programs, transplant programs.
- A
technology is defined as a drug, device, procedure, test, or treatment
rendered in the course of providing health care.
Examples: linear
accelerator machines.
- A
major capital expenditure is defined as an expenditure within the health
care system that meets or exceeds the parameters stated in the Screening
Criteria. Examples:
renovation of a hospital unit, addition of surgical suites.
The CTAAB will review and make recommendations on:
- those proposals that fall within its scope as defined above and
which exceed CTAAB thresholds of $750,000 capital equipment or
incremental community expenditure; or
- Other significant community issues as identified by the payers.
Exceptions will be considered by CTAAB on a case-by-case basis.
In addition to the above-listed criteria, the following issues are of
importance to the community and will always be reviewed regardless of financial
impact: cardiac catheterization
labs, operating rooms, diagnostic and treatment centers, transplant services,
hospital beds, magnetic resonance imaging (MRI) units, positron emission
tomography (PET) scanners, sleep beds, computed tomography (CT) scanners,
lithotripters, and hyperbaric oxygen therapy (HBOT).
Note: As a part of the analysis of a proposal for an incremental CT
scanner, review of ICD-9 or other diagnostic codes will be undertaken to
determine if the current and/or projected volume of scans is justified
only on the basis of cardiac-related procedures.
