The Medical Imaging & Technology Alliance (MITA)—the trade association representing manufacturers of medical imaging equipment, radiopharmaceuticals, contrast media, and focused ultrasound therapeutic devices—is applauding the Centers for Medicare & Medicaid Services (CMS) for its proposal to remove the national non-coverage determination for amyloid PET scans. MITA has submitted comments to CMS supporting this proposal and highlighting the need for CMS to provide coverage of beta-amyloid in a National Coverage Determination (NCD).
Amyloid PET scans are a critical tool that enables clinicians to identify the presence of amyloid plaques and ensure appropriate treatment, MITA officials say. “We agree with CMS that appropriate coverage of amyloid PET scans will greatly reduce provider and patient burden from the existing requirements and test limitations,” they add.
CMS currently imposes a lifetime limit of one amyloid-detecting PET scan per beneficiary and requires enrollment in a clinical trial. Under the CMS proposal, coverage decisions for amyloid PET would be made by regional Medicare Administrative Contractors (MACs) at the local level. Due to the extensive amount of evidence generated, MITA believes CMS should instead provide national coverage for amyloid PET drugs.
“With new treatments directed against amyloid for patients with dementia or Alzheimer’s disease, amyloid PET scans are vital for accurate patient diagnosis and care decisions,” says Patrick Hope, executive director of MITA. “MITA urges CMS to adopt, in the short- and long-term, the most expedient pathway to coverage for this innovative diagnostic to ensure equitable access for all Medicare beneficiaries regardless of where they live.”
