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On July 16 2019, Rep. Scott Peters (CA-52) and Rep. Bobby Rush (IL-01), along with Rep. George Holding (NC-02), introduced the bipartisan Medicare Diagnostic Radiopharmaceutical Payment Equity Act of 2019 (HR 3772). The bill would expand patient access to highly targeted, precision diagnostic radiopharmaceuticals that evaluate conditions such as Alzheimer’s disease, Parkinson’s disease, and some cancers—allowing patients to get the right treatment faster.
In 2008, the Centers for Medicare and Medicaid Services (CMS) began treating diagnostic radiopharmaceuticals as supplies, bundling or “packaging” the drugs with the cost of the procedure in hospital outpatient settings. This decision created a reimbursement structure that limited patient access to innovative diagnostic tools and stifled innovation.
The new bill would ensure that hospitals receive adequate Medicare reimbursement to cover the high-value, low-volume diagnostic radiopharmaceuticals that are used in these nuclear medicine procedures, correcting a flawed payment philosophy and leaving hospitals free to perform the nuclear medicine procedures that patients need.
To ensure the equitable payment of diagnostic radiopharmaceuticals in the Hospital Outpatient Prospective Payment System, we need your help:
Please act today: Send a letter of support for H.R. 3772 to your member of congress. Use this template to help craft a personalized message to your member of congress.