Novitas Proposes Expert panel in response to 2025 AUA Guideline

Pacific Edge today announces it has received notification from Medicare Administrative Contractor (MAC) Novitas that it intends to convene an expert panel to consider coverage for tests mentioned in the 2025 update to the American Urological Association (AUA) microhematuria guideline, including Cxbladder Triage.

The panel — known as a Contractor Advisory Committee (CAC) — is likely to be convened in early 2026. It will be comprised of urology subject matter experts and will be tasked with considering how to bring Medicare policy into alignment with the 2025 update to the AUA guideline.

Pacific Edge notes that under the Medicare Program Integrity Manual, CAC meetings are initiated by the MAC and generally precede the draft issuance of a new or substantially revised Local Coverage Determination (LCD).

Pacific Edge Chief Executive Dr Peter Meintjes said: “We are pleased that Novitas has acknowledged the importance of the AUA microhematuria guideline and is taking a robust and credible approach to policy development by convening a panel of urologists who understand the latest update to the guideline. It is also recognition of the important role that randomized controlled trials like our STRATA¹ study and guidelines play in the development of medical policy like LCDs.”

¹ Lotan et al. (2024). A Multicenter Prospective Randomized Controlled Trial Comparing Cxbladder Triage to Cystoscopy in Patients with Microhematuria. The Safe Testing of Risk for Asymptomatic Microhematuria Trial. The Journal of Urology Vol 212 1-8 Jul 2024.