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WMIS Welcomes CMS Decision: Expanding Coverage for FDG-PET and Ending NOPR Data
Date:6/18/2013

Washington DC (PRWEB) June 18, 2013

On June 11, 2013 the Centers for Medicare & Medicaid Services (CMS) released a final decision memorandum concluding that FDG Position Emission Tomography (PET) is nationally covered to guide subsequent management of anti-tumor strategy, and the agency ended the requirement for prospective data collection. The National Oncological PET Registry (NOPR) was developed jointly by the ACR and WMIS as one of the first projects under the Coverage with Evidence Development (CED) program to determine if FDG-PET scans improve patient outcomes in the diagnosis and disease management for the Medicare population. Based upon the clinical and scientific data developed by NOPR and other researchers, in a landmark decision, CMS expanded coverage without data collection for FDG PET for all cancers for indications that CMS labels as “subsequent treatment strategy”, which includes uses more commonly described as treatment monitoring during therapy, restaging after completion of therapy, detection of suspected recurrence (restaging of patients with documented recurrence to plan additional therapy).

In a proposed decision memorandum, issued on March 13, 2013, CMS had limited coverage of subsequent treatment strategy FDG PET to one scan per patient per cancer, with any additional studies at the discretion of regional Medicare contractors. Based on data submitted by the NOPR and public comments from patient advocacy groups and physicians, CMS revised the final decision to cover three FDG-PET scans per patient. Coverage of any additional FDG-PET scans used to guide subsequent treatment strategy can be determined by regional Medicare contractors.

World Molecular Imaging Society played a leading role in the design and management of the National Oncological PET Registry. “WMIS has worked on a collaborative basis with CMS over the past ten years to develop clinical and scientific evidence and d
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