CMS just says 'No' to sodium fluoride PET
CMS has finalized its proposal of last September not to pay for PET scans using the sodium-fluoride radiopharmaceutical NaF-18, which the agency says still lacks evidence backing it as “reasonable and necessary” in the diagnosis and treatment of cancer that has metastasized to the bones.
In a Dec. 15 decision memo, CMS said that, over the next two years, it will continue reimbursing for NaF-18 PET under coverage with evidence development (CED) conditions, by which CMS reimburses for new drugs and devices while gathering further evidence on clinical efficacy.
CMS had been reviewing NaF-PET reimbursement largely in response to requests from advocates led by the National Oncologic PET Registry (NOPR), which began collecting data supporting NaF-18’s contribution to improved patient management in 2011.
CMS says it will reconsider its national coverage determination “at such time when the evidence has been published in a peer-reviewed journal.”
The decision memo is posted online.
As of press time, NOPR had not yet posted an announcement or alert.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.