The Medical Imaging and Technology Alliance (MITA) has requested that the U.S. Centers for Medicare and Medicaid Services (CMS) reconsider its national noncoverage decision (NCD) for PET tracers and remove exclusionary language that denies coverage for new PET imaging agents.
CMS has had a longstanding policy excluding coverage of PET tracers. MITA believes that removing the NCD policy would allow local coverage decisions, giving regional Medicare carriers the flexibility to evaluate coverage when the U.S. Food and Drug Administration approves new products for medical use. This change also would put PET agents on an equal footing with other imaging technologies and pharmaceuticals.
Last month, MITA convened a PET coverage workshop to consider new pathways for Medicare coverage of PET radiopharmaceuticals and imaging procedures. Representatives from government, medical professional societies, academia, patient groups, and industry gathered to evaluate ways to improve access and promote innovation, which led to the formal request for CMS' reconsideration.
