The U.S. Centers for Medicare and Medicaid Services has been formally asked by representatives from NOPR to expand federal reimbursement for the use of FDG-PET in oncology applications including coverage for the diagnosis, staging and restaging not currently covered by Medicare and Medicaid. A 30-day comment period began April 10, whereby PET advocates can make their case for expanded federal reimbursement.

NOPR was established in May 2006, to collect data on PET's clinical value as a means to help CMS determine if Medicare and Medicaid coverage should be expanded. The petition is the next step in this regulatory process.

NOPR has collected data for the past 18 months from over 1,200 PET facilities all over the United States to see how FDG-PET scans influence cancer treatments plans. This research was published online in March in the Journal of Clinical Oncology. Shortly thereafter, the NOPR forwarded its letter to CMS.

The study, which analyzed 22,975 patients found that FDG-PET prompted changes in the management in 36.5 percent of the cases, and of those cases, FDG-PET results prompted a change from non-treatment to a treatment plan 28 percent of the time. Eight percent of these cases changed from treatment to non-treatment decisions.

The comment period runs through May 10. The agency has proposed making its final decision on or about October 10.

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