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On October 18, 2019, an opinion piece that NorCal CarciNET Community’s Josh Mailman opinion article (“CMS policy shouldn't penalize those with rare disease”) was published by The Hill,  The opinion piece highlighted the challenges with the current method that Medicare/CMS use to pay for radiopharmaceuticals. This webpage provides more information on how this will impact NET patients and providers along with a  tool for those that are interested in taking action.

The Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 (H.R. 3772),  which many in the nuclear medicine community are working on to help improve, will impact Medicare payments for imaging only. This bill is not looking at broader medical payment, billing or cost issues.

Background:

In 2008, Medicare/CMS simplified how CMS paid for PET Imaging. The simplification reduced an infinite combination of supplies and tracers to a few PET bundles based on tracer cost. These bundles allowed a provider to bill for all PET imaging in a simplified manner. The most expensive bundle is ~ $1,400 (there are some regional adjustments).

In June 2017, the Society of Nuclear Medicine and Molecular Imaging held its annual Patient Education Day at their Annual meeting in Denver.

In the first video - Dr. Phelps discusses the concepts behind molecular imaging, while in the second video Dr. Fahey discuss the safety and risks with nuclear imaging and therapy.

Dr. Michael Phelps 

Dr. Fred Fahey 

In June 2017, the Society of Nuclear Medicine and Molecular Imaging held its annual Patient Education Day at their Annual meeting in Denver. The event featured three thoughtful presentation from NET clinicians about the state of NET Management and Nuclear Imaging. NorCal CarciNET Community President, Josh Mailman was also featured on SNMMI TV 

Dr. Hope on Nuclear Medicine for NETs Patients