PT  - JOURNAL ARTICLE
AU  - Bruce J. Hillman
AU  - Richard A. Frank
AU  - Gail M. Rodriguez
TI  - New Pathways to Medicare Coverage for Innovative PET Radiopharmaceuticals: Report of a Medical Imaging & Technology Alliance (MITA) Workshop
AID  - 10.2967/jnumed.111.098947
DP  - 2012 Feb 01
TA  - Journal of Nuclear Medicine
PG  - 336--342
VI  - 53
IP  - 2
4099  - http://jnm.snmjournals.org/content/53/2/336.short
4100  - http://jnm.snmjournals.org/content/53/2/336.full
SO  - J Nucl Med2012 Feb 01; 53
AB  - PET and PET/CT have revolutionized the diagnosis, staging, and monitoring of treatment effect or recurrence for a wide range of cancers and shown promise for improving health outcomes for patients with cardiovascular and central nervous system diseases. However, this technology is challenged by insurance coverage policies that hinder patients’ access to PET and discourage technologic innovation. Recently, the Medical Imaging & Technology Alliance (MITA), a Washington-based industry association, convened a workshop to consider new pathways for making decisions on Medicare coverage of new PET radiopharmaceuticals and imaging procedures that are currently subject to a national noncoverage decision, or “exclusionary rule.” Stakeholders from the government, medical professional societies, academia, patient groups, and industry gathered to brainstorm alternatives to the national noncoverage decision and evaluate their potential to improve access and enhance innovation. Ultimately, MITA, on behalf of the PET community, expects to use the outcomes of the workshop to propose that the Centers for Medicare and Medicaid Services reconsider this current national noncoverage decision for PET and adopt a new framework for coverage.