The Medical Imaging & Technology Alliance (MITA) issued a statement of approval for a recent proposal by the Centers for Medicare and Medicaid Services (CMS) to have local Medicare administrative contractors (MACs) determine coverage for new oncologic PET tracers within their respective jurisdictions.
Currently, new Food and Drug Administration (FDA)-approved PET tracers must go through the national coverage decision process before Medicare and Medicaid will cover the cost of the drug. If the proposal is approved, the policy would remove national non-coverage of FDA-cleared PET oncology tracers that have not been determined nationally and potentially make them available to beneficiaries sooner. However, PET tracers for cardiology and neurology would remain restricted.
“We are encouraged by this first step in removing restrictions for Medicare beneficiaries to access PET procedures,” said Gail Rodriguez, Executive Director of MITA, in a press release. “However, we are concerned that PET tracers for cardiology and neurology remain restricted, and encourage CMS to consider all of the disease areas in which PET is appropriately utilized.”
MITA has vowed to work with CMS to remove the national non-coverage language restricting PET procedures with the use of newly approved cardiac and neurologic tracers.