The U.S. Centers for Medicare and Medical Services (CMS) has opened a review of its coverage policies on FDG-PET for the staging of cervical cancer following the submission of a petition from several nuclear medicine physicians.
Currently, a CMS national coverage determination policy provides for national Medicare coverage for FDG-PET when it is used by a physician to guide the management of cervical cancer in women who have undergone treatment. FDG-PET also is covered nationally for some uses in women diagnosed with cervical cancer who have not yet received anticancer treatment.
Medicare coverage of all other uses of FDG-PET related to cervical cancer is restricted to beneficiaries who are enrolled in a prospective clinical study under a coverage with evidence development (CED) program, such as the National Oncologic PET Registry (NOPR).
The petition asks CMS to change this policy by removing the requirement that beneficiaries participate in a CED program. The petition also asks that the use of FDG-PET not be covered nationally for the diagnosis of cervical cancer, because the modality is not helpful in making an initial diagnosis.
The request for reconsideration comes from Dr. Perry Grigsby, professor of radiation oncology and radiology, and Dr. Barry Siegel, professor of radiology, both of Washington University in St. Louis. Siegel also serves as co-chair of the NOPR Working Group.
The public comment period opened on May 8 and will continue until June 7. CMS expects to announce its proposed decision on November 8 and have a final ruling by February 6, 2010.
Related Reading
CMS expands PET Medicare coverage for cancer patients, April 3, 2009
CMS proposes expansion of PET cancer coverage, January 7, 2009
NOPR: PET changes care of more than a third of cancer patients, October 6, 2008
CMS reconsiders PET coverage framework, September 16, 2008
NOPR asks CMS to expand FDG-PET coverage, April 11, 2008
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