It doesn't look like Medicare will be paying for PET scans of Alzheimer’s patients anytime soon. A panel of the Centers for Medicare and Medicaid Services has affirmed a lower panel’s rejection of PET coverage for the diagnosis and management of Alzheimer’s disease.
PET proponents were hoping that the executive committee of the Medicare Coverage Advisory Committee might overturn a decision reached in January by MCAC’s diagnostic imaging panel. The panel had declined to recommend Medicare payments for PET in Alzheimer’s disease.
But last week the executive committee failed to find any procedural reason to overturn the diagnostic imaging panel’s decision, and voted unanimously to uphold it. The final decision on PET for Alzheimer’s disease now goes to CMS staff, and there is little reason to believe that any new PET coverage will be approved in light of the committee decisions, according to William Uffelman, spokesperson for the Society of Nuclear Medicine (SNM) in Reston, VA.
PET Alzheimer's payments have been undercut by the current standard of care for the disease, which calls for drug therapy for all patients with mild or probable Alzheimer’s, or for those with mild cognitive impairment as defined by the current American Academy of Neurology guidelines. Under these guidelines, there is no reason to use PET to achieve a more definitive diagnosis.
The SNM and other PET proponents will continue to promote Alzheimer’s PET through other channels, according to Uffelman. They are backing a proposal under review at the FDA to approve PET for Alzheimer’s imaging, a move that would allow vendors to market PET scanners for the technique. Other initiatives are targeting the American Academy of Neurology and the Alzheimer’s Association to promote the use of PET as part of the diagnosis and treatment of the disease.
By AuntMinnie.com staff writersApril 22, 2002
Related Reading
New HOPPS rates bring PET reimbursement hike, March 4, 2002
CMS expands PET coverage to breast cancer patients, February 28, 2002
U.S. gives thumbs-down on PET for Alzheimer's, January 11, 2002
CMS tackles FDG-PET reimbursement for Alzheimer’s, January 10, 2002
PET scanning plus new molecular probe detects early Alzheimer's disease in vivo, January 10, 2002
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