New budget legislation signed last week by President Donald Trump will reverse the decision made by the U.S. Centers for Medicare and Medicaid Services (CMS) to remove the pass-through status of several radiopharmaceuticals on January 1.
This action will return the payment rate for these radiopharmaceuticals to their previous price effective October 1 of this year, and this rate will continue until December 31, 2019. The decision does not apply to radiopharmaceuticals that have already fallen off pass-through status, according to a report by the Society of Nuclear Medicine and Molecular Imaging (SNMMI).
In addition, the legislation ordered that the Government Accountability Office (GAO) review CMS' policy for evaluating the position of high-cost drugs and biologics once their pass-through status has expired. The deadline for this report is March 1, 2021.
