Of course, when talking about conditions such as cancer, early diagnosis and appropriate treatment are crucial for improving patient outcomes. America’s patients deserve a health care system that supports and encourages access to innovative imaging techniques.” Diagnostic tests that are less accurate can lead to less optimal treatment decisions. “When it comes at the expense of patients like me who face life-threatening diseases, we have a problem that needs to be fixed. As he acknowledges, most Americans are not in this position. When he was diagnosed with a pancreatic neuroendocrine tumor in 2007, he was fortunate enough to have the resources to be able to travel and pay for innovative diagnostic imaging. Josh Mailman wrote about this issue in a piece for The Hill. The result is that healthcare providers– who are already financially strapped due to the COVID-19 pandemic–are forced to make the choice of taking a financial loss or stop offering the procedure, even though the less expensive alternatives may not provide the needed diagnosis.Īs a result, patients are losing access to these imaging procedures, which may be vital for diagnosis, treatment planning and maintaining their health. At the end of the “pass-through” period, Medicare then “packages” them with the older, lower cost radiopharmaceuticals and the procedure costs.
Initially, Medicare separately reimburses hospitals for the new radiopharmaceuticals. Pass-through status is a transitional period of two to three years during which CMS allows for separate payment of diagnostic radiopharmaceuticals. What is Pass-Through Status and Why Does it Matter? Let’s take a closer look at pass-through status and how you can get involved.
Precision radiopharmaceutical diagnostic imaging procedures help identify abnormalities early in the progress of a disease -before many medical problems are apparent with other diagnostic tests.ĭespite the proven effectiveness of radiopharmaceuticals, such as Axumin and NETSPOT, countless patients are limited in their access because of Medicare’s flawed payment system.Ĭhanges to pass-through status will result in patients who are unable to access these advanced diagnostic procedures.
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