CMS Posts Update for the Reconsideration of Coverage of PET for Oncology Indications

CMS Posts Update for the Reconsideration of Coverage of PET for Oncology Indications

The Centers for Medicare and Medicaid Services (CMS) has posted an update to the National Coverage Analysis (NCA) tracking sheet for FDG PET for brain, cervical, ovarian, pancreatic, small cell lung and testicular cancers (CAG-00181R).

The update to the NCA is the announcement of the Medicare Evidence Development and Coverage Advisory Committee meeting and the amendment of the NCA decision due dates. The text of the announcement is as follows:

CMS will convene the Medicare Evidence Development and Coverage Advisory Committee on August 20, 2008. The panel will review the scientific evidence of the impact of PET as part of a cancer management strategy to improve patient-centered outcomes. The panel will also consider data generated pursuant to prior national coverage determination to cover PET for specified cancers when additional data are prospectively collected.

The amended decision due dates are:
The proposed decision memo due date has been changed from October 10, 2008 to January 10, 2009.

The expected NCA completion date (i.e. final decision) has been changed from January 8, 2009 to April 9, 2009.

Background:
The NCA was opened April 10, 2008 in response to a formal request submitted to CMS by the National Oncologic PET Registry (NOPR) to reconsider FDG PET coverage as set forth in the National Coverage Determinations (NCD) Manual Section 220.6 – PET Scans. Specifically the request is to end the current prospective data collection requirements as required for FDG PET used in the diagnosis, staging and restaging of brain, cervical, ovarian, pancreatic, small cell lung and testicular cancers, as well as for other cancer indications that are only covered through the NOPR.

Note: monitoring response to treatment was not included in the request.

The NCA tracking sheet can be found at::
www.cms.hhs.gov/mcd/viewtrackingsheet.asp?from2=
viewtrackingsheet.asp&id=218&

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