by Gus Iversen
, Editor in Chief | March 29, 2023
The Society of Nuclear Medicine and Molecular Imaging (SNMMI), along with more than 80 stakeholder organizations, celebrated the introduction of H.R. 1199, the Facilitating Innovative Nuclear Diagnostic (FIND) Act of 2023, on February 27 by Representatives Neal Dunn (R-FL), Scott Peters (D-CA), Greg Murphy (R-NC) and Terri Sewell (D-AL).
Many in the industry have become familiar with the FIND Act over the last few years, but what exactly does it do? HCB News sat down with Dr. Munir Ghesani, president of SNMMI, to get some insight into why so many nuclear medicine insiders are excited about the bill's implications.
HCB News: The FIND Act is meant to ensure patients have access to the best radiopharmaceuticals and nuclear medicine diagnostics and treatments. How does it do that?
Dr. Munir Ghesani:
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Many of the newer precision diagnostic radiopharmaceutical drugs have improved the ability of nuclear medicine physicians to diagnose and treat diseases that are particularly prevalent in Medicare patients, such as Alzheimer's disease, prostate cancer, and other cancers. Much of this care takes place in the hospital outpatient setting, where diagnostic radiopharmaceutical drugs are “bundled” into nuclear medicine procedural payments based on averaged costs. Although this bundling process is intended to cover the cost of the diagnostic radiopharmaceutical drug, nuclear medicine staff, imaging equipment, and supplies, in actuality it often does not because of the widely varying costs of the radiopharmaceuticals.
As a result of this practice, hospitals are not receiving adequate payment for the newer precision diagnostic radiopharmaceuticals. Because of the inadequate reimbursement, some hospitals have stopped performing imaging studies using these radiopharmaceuticals, forcing patients to go elsewhere for their testing or to forgo the test altogether.
The FIND Act would require Medicare to adequately reimburse for these lifesaving drugs and procedures by paying for the drugs and procedures separately. By addressing the reimbursement problems, the bill would allow patients of all income levels to have access to these cost-effective diagnostic tools when they need them. Early detection saves lives!
HCB News: Can you describe some specific ways that the current reimbursement rules are compromising patient outcomes?
Because of inadequate reimbursement, some hospitals are not providing nuclear medicine imaging procedures that can precisely and cost-effectively detect conditions such as heart disease, Alzheimer's and Parkinson’s disease, breast and prostate cancer, and neuroendocrine tumors. This limits access to these procedures for Medicare beneficiaries and drives up costs due to ineffective tests and treatments.