US senators introduce legislation to strengthen payment for diagnostic imaging agents
U.S. senators from both political parties have introduced legislation to increase payment for certain diagnostic imaging agents, drawing praise from provider groups Tuesday.
Sens. Marsha Blackburn, R-Tenn., and Tammy Baldwin, D-Wisc., first reintroduced the Facilitating Access to Innovative Diagnostics (or FIND) Act on May 10. House lawmakers proposed a similar companion bill in March.
Currently, Medicare only reimburses for radiopharmaceuticals through a packaged system. But this can create a barrier for those who need newer nuclear imaging agents, advocates note. S.B. 1544 would eliminate this obstacle by requiring HHS to issue separate payment for such agents, using a per-day cost threshold of $500.
The bill has drawn support from numerous professional medical groups. They include the American College of Radiology, American Society of Neuroradiology, the Mayo Clinic Department of Radiology, the Medical Imaging & Technology Alliance, and the Society of Nuclear Medicine & Molecular Imaging.
PET is a crucial tool for diagnosing diseases such as prostate cancer and Alzheimer’s, supporters noted. Yet, this obstacle is preventing patients from accessing the modality.
“Unfortunately, a Medicare payment policy makes these tests largely unavailable,” Rachel Conant, VP of federal affairs for the Alzheimer's Association, said in a May 16 announcement from both lawmakers. “We are grateful to Sens. Blackburn and Baldwin for reintroducing the bipartisan FIND Act, which will increase patient access to functional imaging and improved diagnosis accuracy.”
Each year, over 20 million Americans benefit from the use of diagnostic and therapeutic radiopharmaceuticals, which are needed for nuclear medicine procedures, advocates noted. They’re essential for treating other diseases such as Parkinson’s (the Michael J. Fox Foundation also is a supporter), breast and prostate cancer, heart disease, and neuroendocrine tumors. “Flawed” reimbursement methodology, however, continues to discourage hospitals from using them.
“Anyone who’s battled diseases like cancer or Alzheimer’s knows what a difference a clear and early diagnosis can make,” Sen. Baldwin said in a statement. “Advanced imaging can be that difference, helping identify and diagnose a disease, inform more timely and appropriate treatment plans, and improve overall healthcare outcomes.”
Members of the U.S. House and Senate previously introduced the FIND Act in 2021, but the proposals failed to reach the president’s desk.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.