News | Radiopharmaceuticals and Tracers | October 12, 2018

CORAR Supports Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2018

Federal legislation would institute separate payment policy for diagnostic radiopharmaceuticals under the Medicare Hospital Outpatient Prospective Payment System (OPPS)

CORAR Supports Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2018

October 12, 2018 — The Council on Radionuclides and Radiopharmaceuticals Inc. (CORAR) — the voice of the radionuclide, radiopharmaceutical and nuclear pharmacy industries in North America — strongly supports legislation recently introduced by Congressman George Holding (R-NC-2) and Seth Moulton (D-MA-6). This legislation, designated H.R. 6948 - Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2018, would direct the Secretary of Health and Human Services to recognize diagnostic radiopharmaceuticals (RPs) as drugs and institute a separate payment policy under the Medicare Hospital Outpatient Prospective Payment System (OPPS).

According to the Society of Nuclear Medicine and Molecular Imaging (SNMMI), more than 20 million Americans benefit each year from nuclear medicine procedures.1 Diagnostic RPs are drugs necessary for all nuclear medicine imaging studies to diagnose and determine the severity of disease. Nuclear medicine imaging procedures are effectively used in the diagnosis and treatment of disease states such as cardiovascular disease, some forms of cancer, Parkinson’s Disease, thyroid disease and epilepsy.

Diagnostic and therapeutic RPs are statutorily considered drugs and are regulated as drugs by the Food and Drug Administration. However, since 2009 diagnostic RPs under the OPPS have been packaged with the procedure into Ambulatory Payment Classifications (APCs) for a bundled payment to hospitals while therapeutic RPs continue to be paid separately. Diagnostic RP costs may vary widely within a nuclear medicine APC with some diagnostic RP costs significantly exceeding the APC payment rate.

The Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2018 will ensure that diagnostic RPs are recognized as drugs and that all diagnostic RPs are appropriately paid under the OPPS. This will safeguard patient access to newer precision diagnostic RPs and support more innovation to improve clinical outcomes and deliver more cost-effective care, according to CORAR.

For more information: www.corar.org

Reference

  1. Society of Nuclear Medicine and Molecular Imaging, http://www.snmmi.org/ClinicalPractice/content.aspx?ItemNumber=4825

Related Content

New Phase 2B Trial Exploring Target-Specific Myocardial Ischemia Imaging Agent
News | Radiopharmaceuticals and Tracers | May 17, 2019
Biopharmaceutical company CellPoint plans to begin patient recruitment for its Phase 2b cardiovascular imaging study in...
Blue Earth Diagnostics Expands Access to Axumin in Europe
News | Radiopharmaceuticals and Tracers | May 13, 2019
Blue Earth Diagnostics announced expanded access to the Axumin (fluciclovine (18F)) imaging agent in Europe. The first...
Shine Medical Technologies Breaks Ground on U.S. Medical Isotope Production Facility

Image courtesy of Amen Clinics

News | Radiopharmaceuticals and Tracers | May 10, 2019 | Jeff Zagoudis, Associate Editor
Shine Medical Technologies Inc. broke ground on their first medical isotope production facility in Janesville, Wis. U.S...
A 3-D printed tungsten X-ray system collimator. 3D printed, additive manufacturing for medical imaging.

A 3-D printed tungsten X-ray system collimator. The tungsten alloy powder is printed into the form desired and is laser fused so it can be machined and finished. Previously, making collimators from Tungsten was labor intensive because it required working with sheets of the metal to create the collimator matrix. 

Feature | Medical 3-D Printing | April 29, 2019 | By Steve Jeffery
In ...
NIH Study of Brain Energy Patterns Provides New Insights into Alcohol Effects

NIH scientists present a new method for combining measures of brain activity (left) and glucose consumption (right) to study regional specialization and to better understand the effects of alcohol on the human brain. Image courtesy of Ehsan Shokri-Kojori, Ph.D., of NIAAA.

News | Neuro Imaging | March 22, 2019
March 22, 2019 — Assessing the patterns of energy use and neuronal activity simultaneously in the human brain improve
Improving Molecular Imaging Using a Deep Learning Approach
News | Nuclear Imaging | March 21, 2019
Generating comprehensive molecular images of organs and tumors in living organisms can be performed at ultra-fast speed...
PET Scans Show Biomarkers Could Spare Some Breast Cancer Patients from Chemotherapy
News | PET Imaging | March 18, 2019
A new study positron emission tomography (PET) scans has identified a biomarker that may accurately predict which...
Researchers Create New Method for Developing Cancer Imaging Isotopes

Prototype fluidic system for zirconium-89 purification. Image taken through a hot cell window at the Department of Radiology, University of Washington. Image courtesy of Matthew O’Hara, Pacific Northwest National Laboratory

News | Radiopharmaceuticals and Tracers | March 14, 2019
A team of researchers at the University of Washington announced they developed a new automated system for producing...
Siemens Healthineers Announces First U.S. Install of Biograph Vision PET/CT
News | PET-CT | March 06, 2019
Siemens Healthineers’ new Biograph Vision positron emission tomography/computed tomography (PET/CT) system has been...