Medicare Proposes Expanded Coverage and New Studies of Fdg-Pet For The Diagnosis of Alzheimer's Disease

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The Centers for Medicare & Medicaid Services (CMS) announced Tuesday, June 15 that it intends to expand Medicare coverage of positron emission tomography (PET) to include some Medicare beneficiaries with suspected Alzheimer's disease. CMS will accept public comments on the draft decision memorandum for 30 days, and will make the decision final within 90 days.

"This new Medicare coverage will improve care for Americans living with suspected Alzheimer's disease," Health and Human Services Secretary Tommy G. Thompson said. "It is one of the many ways we're working to help our Medicare beneficiaries with cognitive impairment get the best possible care based on the best scientific evidence."

With input from independent experts, including the National Institute on Aging and the Alzheimer's Association, CMS completed an exhaustive review of the evidence regarding the use of PET for diagnosis of Alzheimer's disease after receiving a request to reconsider its previous non-coverage decision. Based on this scientific review, CMS determined that use of PET for the diagnosis of suspected AD would be covered for patients when a specific diagnosis remains uncertain despite a thorough clinical evaluation. In addition, in view of indications of the potential benefit of PET, Medicare will also cover PET in other patients with early dementia or unexpected memory loss who are enrolled in clinical trials with certain safeguards for patients, including informed individualized analysis and evaluation of test results and health status.

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"To increase access of Medicare beneficiaries to innovative technology that will improve health outcomes, we will use the best and latest clinical evidence in our coverage decisions - and we will work to improve the evidence when important questions remain," CMS Administrator Mark McClellan, M.D., Ph.D. said. "In addition to expanding PET coverage, Medicare will collaborate with the National Institutes of Health to develop needed evidence on the role of PET scans in guiding treatment and predicting the course of Alzheimer' s disease.

Alzheimer's disease is an age-related and irreversible brain disorder that occurs gradually and results in memory loss, behavior and personality changes, and a decline in thinking abilities. It is the most common cause of dementia, representing approximately two-thirds of cases.

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The source of this release is http://www.cms.hhs.gov

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