Reimbursement News
CMS Maintains Coverage of CCTA
On March 12, the Centers for Medicare & Medicaid Services (CMS) announced that no national coverage determination (NCD) is appropriate for cardiac CT angiography (CCTA) to diagnose coronary artery disease (CAD)—and thus, Medicare reimbursement remains intact. In a final decision memo that was issued a day earlier than expected, CMS maintained the status quo that coverage should be determined by local contractors through the local coverage determination process or case-by-case adjudication.
When CMS first proposed the coverage decision in December 2007, the agency proposed to withdraw all local coverage (coverage for CCTA exists in all 50 states) and initiate a national coverage decision, which would have required the initiation of a clinical trial to establish whether CCTA is useful for patients with two narrow indications: symptomatic patients with chronic stable angina at intermediate risk of CAD, or symptomatic patients with unstable angina at a low risk of short-term death and intermediate risk of CAD. Critically, no detail was provided as to how that clinical trial would be constructed, leaving the CCTA market in flux.
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Industry News
Positron Emission Tomography Included in Guidelines for Evaluation of Early-Stage Lung Cancer Patients: Presented at NCCN
New guidelines from the National Comprehensive Cancer Network give emphasis to the use of fluorodeoxyglucose (FDG)-positron emission tomography (PET) scanning for the evaluation of patients diagnosed with early-stage non-small-cell lung cancer (NSCLC).
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CMS to Pay $666M to Hospitals in Settlement
The Centers for Medicare & Medicaid Services (CMS) has agreed to pay 667 hospitals $666 million to settle a reimbursement policy lawsuit that began in the 1980s.
The deal, resulting from negotiations under way since April 2006, is among the largest government settlements paid to healthcare providers, according to the Wall Street Journal.
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Industry News
NOPR Data Confirm FDG PET Has Major Impact on Management of Cancer
Clinicians changed the intended care of more than one in three cancer patients as the result of FDG-PET scan findings, according to a study of data from the National Oncologic PET Registry, published online March 24 in the Journal of Clinical Oncology (JCO).
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Customer Spotlight
Positron Emission Mammography (PEM) at Northern California PET Imaging Centers
Northern California PET Imaging Center (NCPIC) at their Sacramento site, has purchased a Naviscan PET Systems PEM Flex™ Solo II PET scanner. This new scanner provides high diagnostic accuracy for breast cancer patients, with the ability to detect breast cancer lesions as small as 1.5 – 2.0 mm, and image quality that is not compromised by dense breasts, fibrocystic breasts or implants.
Under an initiative funded by a grant from the Sacramento Valley Affiliate of Susan G. Komen for the Cure, NCPIC provides PEM scans for underinsured breast cancer patients. This collaboration provides PEM imaging to breast cancer patients who may not have access to the latest technology and/or for high risk patients who may have had a non-diagnostic mammogram due to dense breasts, fibrocystic disease or implants.
This new service offering at NCPIC yields three primary results of direct benefit to patients. Women will have access to a test that they may not otherwise have had access to without the help of this grant. Patients with difficult-to-diagnose breast disease will have valuable information related to whether they have a cancerous lesion or not. Finally, some patients with diagnosed breast cancer who may have had an MRI will now have information to help determine a more precise surgical management plan.
Northern California PET Imaging Center was established in 1992 as a not-for-profit community benefit organization committed to providing the most advanced Positron Emission Tomography (PET) Services to the Northern California region. NCPIC is the result of a joint sponsorship between Mercy Healthcare, Sacramento and Sutter Healthcare, Sacramento and is known as a center of excellence, providing innovative technology and quality care for patients. For more information, call (916) 737-3211 or visit www.ncpic.org.
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