Blackburn, Colleagues Urge CMS Administrator to Improve Access to Diagnostic Scans for Medicare Patients

June 25, 2024

NASHVILLE, Tenn. – U.S. Senator Marsha Blackburn (R-Tenn.) led a bipartisan group of Senate colleagues in sending a letter to U.S. Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure requesting CMS improve patients’ access to Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) scans by addressing inadequate packaging of payment for diagnostic radiopharmaceuticals used in all PET and SPECT scans.

These diagnostic scans help physicians identify certain diseases more effectively, including Alzheimer’s, Parkinson’s, advanced cardiovascular disease, and prostate cancer.

PET/SPECT Scans Ensure Patients Receive Proper Treatment and Save Medicare Resources

“We write to express our support for Medicare beneficiary access to Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) scans. All PET and SPECT scans use diagnostic radiopharmaceuticals to enable physicians to more effectively diagnose diseases such as Alzheimer’s, Parkinson’s, advanced cardiovascular disease, and prostate cancer. These scans ensure that patients are put on the proper path for treatment of their medical condition, which saves Medicare’s resources… We ask that you advance this work during the CY 2025 OPPS process so that patients can receive these PET and SPECT scans more widely in the hospital outpatient setting.”

All PET/SPECT Scans Use Diagnostic Radiopharmaceuticals to Diagnose Diseases

“Today, a new generation of precision radiopharmaceuticals are used in PET and SPECT imaging for targeted patient populations to identify and characterize specific disease states. In some cases, these are the only diagnostic tests for a disease; in other cases, they offer diagnostic advantages over previous generations of radiopharmaceuticals. The radiopharmaceutical is essential to the scan—without it, the scan cannot be performed. Alzheimer’s Disease illustrates the importance of these scans to patients and the impact CMS’s payment policies have on the availability of PET scans. In Alzheimer’s Disease, precision diagnostic radiopharmaceuticals are used to identify beta-amyloid plaque in the brain, which assists physicians in precisely diagnosing Alzheimer’s disease.”

CMS Must Address Payment Packaging for Diagnostic Radiopharmaceuticals to Improve Medicare Beneficiaries’ Access to Care

“Because treatments are approved for use on people in the early stages of illness, delayed access to amyloid PET scans means more people lose the opportunity to qualify for treatment as their disease progresses… We have heard from patients and providers about similar access issues for patients seeking nuclear medicine scans for Parkinson’s Disease, prostate and other cancers, as well as certain cardiac conditions. We have heard about patients having to drive extremely long distances past several health systems to a provider who offers these scans. Physicians have also stated that they have needed to refer their patients outside their health system to receive the most accurate diagnostic scans due to the inadequacy of the packaged reimbursement methodology… We urge CMS to address packaging of payment for diagnostic radiopharmaceuticals. This action is critical to ensure that Medicare beneficiaries have access to appropriate care in their communities.”


U.S. Senators Tammy Baldwin (D-Wisc.), Shelley Moore Capito (R-W.Va.), Tammy Duckworth (D-Ill.), Cindy Hyde-Smith (R-Miss.), Jon Tester (D-Mont.), James Lankford (R-Okla.), Martin Heinrich (D-N.M.), Susan Collins (R-Maine), Jeanne Shaheen (D-N.H.), Eric Schmitt (R-Mo.), Maggie Hassan (D-N.H.), Steve Daines (R-Mont.), Joe Manchin (I-W.Va.), and Gary Peters (D-Mich.) co-signed this letter.

Click here to view the full letter.