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Alliance Applauds CMS Proposal to Withdraw Requirement Limiting Access to PET Scans

Published July 18, 2023

A physician explaining a brain scan to a patient.

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released a proposed decision memo regarding the existing national coverage determination (NCD) requiring coverage with evidence development (CED) for Beta Amyloid Positron Emission Tomography (Aβ PET) scan use for patients with dementia, Alzheimer’s, and other neurodegenerative diseases.

Currently, under the NCD, only one Aβ PET scan is covered per lifetime for Medicare beneficiaries. These scans are instrumental in diagnosis, treatment assessment, and monitoring of Alzheimer’s disease.

“All of us at the Alliance for Aging Research are thrilled about the CMS announcement proposing to withdraw its Medicare NCD requiring CED for Aβ PET scans,” said Sue Peschin, President & CEO of the Alliance for Aging Research. “Timely and equitable access to Aβ PET scans is critical for Medicare beneficiaries to realize the benefit of FDA-approved disease-modifying therapies. We thank the Administration and CMS for standing with people living with Alzheimer’s and their families, and not in their way.”

The Alliance has been a champion for reversal of this limitation imposed by the Medicare program. Most recently, in December 2022, the Alliance and 52 additional organizations shared a letter with President Biden urging him to direct the Secretary of the U.S. Department of Health and Human Services to reopen the Aβ PET NCD for a full reconsideration. In July 2022, the Alliance led 19 other organizations in asking Medicare to end restrictions to Alzheimer’s disease diagnostics, including Aβ PET scans.

This week’s proposed decision is the first step in this process and initiates a 30-day public comment period. According to the memo, the final decision will be posted within 60 days after the public comment period closes.

If you are a member of the media and want to learn more or interview Alliance staff on this issue, email Katie Riley, Vice President of Communications, at [email protected].

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