FIND Act 2023 will improve patient access to nuclear medicine scans through separate medicare reimbursement policy
The Society of Nuclear Medicine and Molecular Imaging (SNMMI), along with more than 80 stakeholder organizations, supports and applauds the introduction of H.R. 1199, the Facilitating Innovative Nuclear Diagnostic (FIND) Act of 2023. The legislation was introduced on February 27 by Representatives Neal Dunn (R-FL), Scott Peters (D-CA), Greg Murphy (R-NC) and Terri Sewell (D-AL).
Nuclear medicine scans are often the most effective and cost-effective way to diagnose a wide range of diseases, including heart disease, cancer, and brain disease. Their high level of precision in detecting disease is unmatched and often results in better patient outcomes—yet the way these scans are reimbursed can seriously reduce access to these potentially game-changing tools.
“The current Medicare reimbursement structure disincentivizes hospitals and providers from offering crucial testing that can often lead to earlier diagnosis and more accurate treatments,” said Munir Ghesani, MD, FACNM, FACR, SNMMI president. “If passed, this bill would give patients greater access to a wide range of procedures and also help providers better manage costs while delivering more targeted and cost-efficient care.”
Under Medicare, the radiopharmaceuticals used in nuclear medicine scans are bundled with procedure payments instead of being paid separately, and the bundled payment does not adequately cover their cost. Inadequate reimbursement impacts the availability of the procedures, which in turn affects patient access. Ultimately, Medicare pays for unnecessary therapies, surgeries, and hospital stays.
The FIND Act would direct the Secretary of Health and Human Services to institute a separate payment policy under the Medicare Hospital Outpatient Prospective Payment System for diagnostic radiopharmaceutical drugs brought to market after January 1, 2008, that exceed a per-day cost threshold of $500. This change will ensure that patients receive medically appropriate tests that provide the most accurate diagnosis and treatment plans.