CMS said in a Proposed Decision Memorandum that local Medicare Administrative Contractors (MACs) may determine coverage of Positron Emission Tomography (PET) within their local jurisdictions, a tentative win for the imaging industry. PET is a minimally invasive diagnostic imaging procedure used in conditions such as cancer, ischemic heart disease and some neurologic disorders. The Medical Imaging & Technology Alliance (MITA) asked CMS to reconsider the National Coverage Determination that excluded PET coverage to permit local MACs to make determinations for PET using new proprietary FDA approved radio-pharmaceuticals. MITA asked CMS to “remove the current non-coverage language as it pertains to new PET radiopharmaceuticals that receive approval from the FDA.” In response, CMS has proposed that local MACs “may determine coverage within their respective jurisdictions for PET using radiopharmaceuticals for their labeled indications for oncologic imaging that are approved by the FDA. The effect of the decision, if finalized without change, would be to remove the national noncoverage for some uses of radiopharmaceuticals that have not been more specifically determined nationally,” CMS said. Comments on the proposed decision are being accepted until January 12, 2013. CMS’ Proposed Decision Memo is available here.
Register now for your free, tailored, daily legal newsfeed service.
Questions? Please contact email@example.comRegister
CMS proposes relaxed coverage consideration of PET scans
Popular articles from this firm
If you would like to learn how Lexology can drive your content marketing strategy forward, please email firstname.lastname@example.org.
Related topic hubs
Principal Trust Specialist
RBC Wealth Management
"Lexology is a great service, providing easy access to a variety of relevant articles from a number of information providers across different geographical zones -- I just wanted to say thank you to all who are involved in providing this reference!"