news

WASHINGTON, DC — Representatives Paul D. Tonko (D-NY) and Darin LaHood (R-IL) today cheered the recent proposed decision from the Centers for Medicare & Medicaid Services (CMS) announcing Medicare coverage determinations for PET beta amyloid imaging to be made by the Medicare Administrative Contractors, thereby sidestepping bureaucratic hurdles and allowing broader coverage and access to these diagnostic tests, which are able to detect Alzheimer’s years and even decades before the onset of symptoms.

Tonko and LaHood have been at the forefront in Congress pushing to support individuals living with Alzheimer’s disease and open up avenues for treatment. Last year, they led a letter with Reps. Nanette Diaz Barragán (D-CA), and Fred Upton (R-MI) urging CMS to expand access to these PET beta amyloid imaging diagnostic tests.

With recent encouraging movement on treatments to slow Alzheimer’s, ensuring access to these diagnostic scans is more important than ever.

“Evidence shows the critical importance of early diagnosis for Alzheimer’s patients and their caregivers in determining the best path forward in developing an effective, quality care plan,” the members said. “Despite this, PET beta amyloid imaging, which is proven in helping determine early diagnosis, was severely limited in coverage under Medicare by red tape that most significantly impact communities of color, rural, and disadvantaged groups. We’ve long been pushing for improved access to this diagnostic test and are pleased to see CMS move forward with this compassionate, science-based proposed decision. Following this encouraging step, the work continues to support the millions of Americans and their families impacted by Alzheimer’s and drive the research to, one day, find a cure to this disease.”

Under Medicare currently, coverage is severely limited to one scan per patient per lifetime with the added barrier that patients must be enrolled in a clinical trial for the scan to be covered. Without coverage, the out-of-pocket cost on average is $3,000 per scan or more.