Medicare to cover PET for Alzheimer's imaging

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On the heels of President Ronald Reagan's death from Alzheimer's disease and just a week before the start of the annual Society of Nuclear Medicine meeting in Philadelphia, PET facilities got some good news. The Centers for Medicare & Medicaid Services this week (CMS) announced that it intends to expand Medicare coverage of positron emission tomography (PET) to include some Medicare beneficiaries with suspected Alzheimer's disease.

The intention is to provide Medicare coverage of PET scans to aid physicians in the early diagnosis of Alzheimer's disease and to help differentiate Alzheimer's from other neurological disorders.

The draft decision is open to public comments for 30 days. CMS will make the decision final within 90 days.

With input from independent experts, including the National Institute on Aging and the Alzheimer's Association, CMS said it completed a review of the evidence regarding the use of PET for diagnosis of Alzheimer's disease after receiving a request to reconsider its previous non-coverage decision.

Based on this scientific review, CMS determined that use of PET for the diagnosis of suspected Alzheimer's disease would be covered for patients when a specific diagnosis remains uncertain despite a thorough clinical evaluation.

In addition, in view of indications of the potential benefit of PET, Medicare will also cover PET in other patients with early dementia or unexpected memory loss who are enrolled in clinical trials with certain safeguards for patients, including informed individualized analysis and evaluation of test results and health status.

The Society of Nuclear Medicine (SNM) praised the announcement. "We are very pleased the CMS has taken a positive step toward recognizing the benefits and advantages of PET for the diagnosis of suspected AD [Alzheimer's disease]," said SNM President Henry D. Royal, MD. "Alzheimer's is a devastating disease and an earlier diagnosis opens the possibility for more effective treatments. This positive step by the CMS is the result of years of collaboration and hard work by many organizations to collect and disseminate data on early diagnosis and the role of PET.

CTI Molecular Imaging Inc. President and CEO Ronald Nutt, PhD, also applauded the pending reimbursement. "CMS has recognized the significant benefit that PET can provide in the diagnosis of patients suspected of having Alzheimer's disease. PET will provide the opportunity for earlier diagnosis, care and treatment of Alzheimer's patients, while also helping to better manage the overall resources applied to care of patients with Alzheimer's disease and associated disorders. We believe that this coverage decision will help to alleviate the anxiety and uncertainty experienced by Alzheimer's patients and their families."