Cancer Clinical Trial
Official title:
The National Oncologic PET Registry
The Centers for Medicare & Medicaid Services (CMS), as the Federal agency that administers the Medicare program, only pays for positron emission tomography (PET) scans in patients with cancer for certain reasons and for certain types of cancer. This study was developed to help CMS determine if they should pay for PET scans for additional reasons and additional types of cancer. In order to collect the information needed to decide which other types of cancer should be covered by Medicare, CMS will provide payment for the otherwise non-covered PET scans of patients who are properly registered with the National Oncologic PET Registry (NOPR). This information will then be analyzed to determine the effect PET scans had on the way physicians planned to treat their patients.
The National Oncologic PET Registry (NOPR) was developed in response to the Centers for
Medicare & Medicaid Services (CMS) proposal to expand coverage for positron emission
tomography with F-18 fluorodeoxyglucose (FDG-PET) to include cancers and indications not
presently eligible for Medicare reimbursement. Under this coverage with evidence development
(CED) program, Medicare reimbursement for these cancers can be obtained if the patient's
referring physician and the provider submit data to a clinical registry to assess the impact
of PET on cancer patient management. The NOPR implemented this registry for CMS. The NOPR is
sponsored by the World Molecular Imaging Society (formerly the Academy of Molecular Imaging),
and managed by the American College of Radiology through the American College of Radiology
Imaging Network.
The original goal of the National Oncologic PET Registry was to assess the effect of positron
emission tomography with F-18 fluorodeoxyglucose (FDG-PET) on referring physicians' plans of
intended patient management for those cancers and indications not currently eligible for
reimbursement from CMS. Data were collected from the referring physician before and after the
PET study. If complete and timely data are reported to the NOPR within 30 days of the PET
scan, the PET facility and interpreting physician (nuclear physician/radiologist) are
eligible for reimbursement by CMS. Based in part on data obtained from the NOPR, CMS expanded
coverage for FDG-PET in patients with cancer on April 3, 2009 and further expanded coverage
on June 11, 2013. Specifically, on June 11, 2013, CMS issued a final decision memorandum
ending the prospective data collection requirements under CED for all oncologic indications
for FDG-PET. Overall accrual to the FDG-PET registry was nearly 288,000 scans.
On February 26, 2010, CMS announced its decision to cover the use NaF-18 PET to identify bone
metastasis. Under this new policy, the use of NaF-18 PET would be covered only under an
approved (CED) program. The NOPR obtained CMS approval to develop a registry for NaF-18 as an
amendment to the then-existing NOPR for FDG-PET. The NaF-18 PET registry component of NOPR
was activated for accrual on February 7, 2011. Estimated total accrual to the NaF-PET
registry is 45,000 cases.
As with the registry for FDG-PET, the goal of the NaF-18 PET registry component is to assess
the impact of this imaging examination on referring physicians' plans of intended management
of patients with known or suspected osseous metastatic disease. Data are collected from the
referring physician before and after the PET study, as well as from the interpreting
physician. If complete and timely data are reported to the NOPR within 30 days of the PET
scan, the PET facility and interpreting physician (nuclear physician/radiologist) are
eligible for reimbursement by CMS.
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