CMS plan recognizes PET technology for benefit of cancer patients

01/31/05

RESTON, Va.--The Centers for Medicare & Medicaid Services (CMS) announced a plan Jan. 28 that will lead to reimbursement for a broad range of oncology studies with positron emission tomography (PET)--increasing a cancer patient's access to this modality and thus improving the diagnosis and treatment of cancer patients nationwide. The plan will link reimbursement to a national patient database created by CMS to track clinical management decisions of cancer patients.

"SNM applauds this move by CMS to recognize the value of PET in the co-management of the nation's cancer patients," said Society of Nuclear Medicine President Mathew L. Thakur, Ph.D. "This action will give thousands of cancer patients the benefit of the superior diagnosis and treatment capabilities of this exciting imaging technology," agreed Peter S. Conti, M.D., Ph.D., SNM president-elect and chair of SNM's PET Center of Excellence.

According to CMS, this decision reflects Medicare's emphasis on ensuring that patients receive high-quality, medically necessary care and on developing better evidence needed by linking coverage to the collection of clinical data.

PET is a diagnostic imaging procedure that has the ability to differentiate cancer from normal tissue and may add important information beyond conventional imaging studies in diagnosing and staging cancer and monitoring a patient's progress during treatment. The expansion in PET scan benefits makes this test available to patients when the patient and doctor participate in high-quality clinical studies or submit information to a PET database. This database will be available within the next several months.

This move will also directly impact thousands of SNM physicians and technologists. The creation of a national PET database may lead to reimbursement for the diagnosis, monitoring the effectiveness of treatment, restaging and suspected recurrence of cancers not previously covered, such as cervical, ovarian, pancreatic and testicular cancers. Previously, only a limited number of indications were covered.

CMS worked with the National Cancer Institute (NCI) and the oncology community, including SNM, the American College of Nuclear Physicians, the American College of Radiology and the Academy of Molecular Imaging, to ensure that patients get the care they need and to develop the evidence needed by doctors and patients to make informed decisions about treatment. "Ultimately, our working relationship with CMS is about improving the quality of and access to cancer care for patients everywhere," said Andrew von Eschenach, M.D., NCI director.

CMS will hold an open door forum Feb. 14 on this topic to obtain public input on linking coverage to practical trials and databases.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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