Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer

CAG-00065R2

Expand All Comments | Collapse All Comments

Comment Period:

Sort By:

Public Comments

Total Comments: 221

Commenter	Comment Information
Li, Yi	Title: Radiologist Organization: Good Samaritan Hospital Date: 10/16/2015 Comment: NaF-18 PET imaging is a very good tool which will significantly improve the outcome of diagnosis. We should have it for daily medical practice.
Ambrosy, Dolores	Title: Imaging Manager and Chief Technologist Date: 10/16/2015 Comment: In my twenty years as a Nuclear Medicine Technologist it has become clear to me that Sodium Flouride Bone scans are FAR SUPERIOR to planar bone scans. MDP bone scan usually lead to further imaging because of inconclusive findings which create an inconvenience for the patient. This creates a situation where a patient needs further testing!! I have also witnessed situations where planar bone scan might be read as having slightly increased areas of uptake which may not look like metastasis when in fact, there is a metastasis present. Sodium Flouride scans are far more sensitive and specific than planar bone imaging with MDP. Furthermore, after performing both examinations on patients I have concluded that the Sodium Flouride scan is more convenient to the patient as they do not have to leave the imaging center for three to four hours as is usual for MDP planar bone scans. Less In my twenty years as a Nuclear Medicine Technologist it has become clear to me that Sodium Flouride Bone scans are FAR SUPERIOR to planar bone scans. MDP bone scan usually lead to further imaging because of inconclusive findings which create an inconvenience for the patient. This creates a situation where a patient needs further testing!! I have also witnessed situations where planar bone scan might be read as having slightly increased areas of uptake which may not look like metastasis More
Bonvicino, Marie	Title: MD Organization: Life Line Medical Date: 10/16/2015 Comment: F-18 Sodium fluoride PET bone scanning is far superior to the regular bone scans in our area. Here are some cases: 1.) A 65 year old with lung cancer, FDG scan shows disease above right hip, and disease in front of left hip. For some reason one of our physicians orders a regular bone scan which is read as “”negative””.. “”There is no scintigraphic evidence of bony metastases, despite suspicious findings on the recent [FDG} PET scan”“; “”Normal bone scan”“ (SIC). This regular bone scan caused confusion, and a F-18 Sodium fluoride PET bone was ordered and confirmed FDG results. The regular bone scan totally confused the issues!!! 2.) 49 year old with severe back pain, MRI suggests: “”malignacy in several pedicals.””Subsequent regular bone scan read as: “”compatible with metastatic bone disease””. WRONG!! F-18 Sodium fluoride PET bone scanning shows NO disease related to malignancy, but several degenerative ribs abutting vertebrae and benign uptake related to a screw in the spine. !!! Regular bone scan and MRI BOTH WRONG!!! Should have done F-18 Sodium fluoride PET bone scanning first; would have saved money over MRI and over useless regular bone scan. 3.) 75 year old female with history of breast carcinoma, more recent severe back pain, a physician ordered an MRI which “Suggests” metastatic lesion in L4. An FDG study was obtained which was negative in the lumbar spine, no explanation for back pain. F-18 Sodium fluoride PET bone scanning shows NO disease in L4, AND intense uptake in the posterior elements of L5/S1, the cause of the patients back pain!!!! DONE !! Not approving F-18 Sodium fluoride PET bone scanning makes absolutely no sense!!! MRI has very poor specificity, and regular bone scans have no clue as to what they are looking at… Less F-18 Sodium fluoride PET bone scanning is far superior to the regular bone scans in our area. Here are some cases: 1.) A 65 year old with lung cancer, FDG scan shows disease above right hip, and disease in front of left hip. For some reason one of our physicians orders a regular bone scan which is read as “”negative””.. “”There is no scintigraphic evidence of bony metastases, despite suspicious findings on the recent [FDG} PET scan”“; “”Normal bone scan”“ (SIC). This More
Hertel, Donald	Title: Manager, Medicare Starategy Unit Organization: Mayo Clinic Date: 10/16/2015 Comment: Commenter: Roarke, Michael Title: Consultant Diagnostic Radiology Organization: Mayo Clinic Date: 10/13/2015 Comment: Tamara Syrek Jensen, JD Director, Coverage and Analysis Group Centers for Medicare and Medicaid Services Dear Ms. Syrek Jensen: On behalf of Mayo Clinic we appreciate the opportunity to submit public comments to the Centers for Medicare & Medicaid Services (CMS) Proposed Decision Memo for Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2). CMS proposes that the evidence is sufficient to determine that use of a NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer is not reasonable and necessary to diagnose or treat an illness or injury or to improve the functioning of a malformed body member and, therefore, is not covered under § 1862(a)(1)(A) of the Social Security Act. In addition, CMS proposes to continue the requirement for coverage with evidence development (CED) for 12 months to allow for confirmatory analyses to be performed and resulting evidence to be published to definitely answer the following questions: Does the addition of NaF-18 PET imaging lead to: A change in patient management to more appropriate palliative care; or A change in patient management to more appropriate curative care; or Improved quality of life; or Improved survival? Mayo Clinic supports the CMS coverage of NaF-18 PET scan, removing the “coverage with evidence development (CED)” restriction. We strongly believe the data and clinical experience have demonstrated the incremental value of NaF-18 PET imaging as the most sensitive and specific way to detect osteoblastic bone metastases. NaF-18 PET is more sensitive and specific than the conventional Tc-MDP bone scan. Use of NaF-18 PET have altered treatment recommendations in a significant number of prostate cancer patients. It is important that this test be offered and covered for our patients in order to continue to provide the highest quality imaging and most appropriately prescribed treatments. Please refer to the following supporting materials from our clinical experience on NaF-18 PET (with cited scientific evidence), published literature on diagnostic benefits of NaF-18 PET, as well as the perspectives of impact related to 99mTc shortage. Clinical Experience In our practice, the clinical benefit of NaF-18 PET over conventional 99mTc bone scintigraphy relates to: 1) Higher sensitivity for detection of smaller bone metastases. This is very important for preoperative evaluation of cancer patients, particularly in patients with predominantly osteolytic lesions. The detection of just one small bone metastasis in such patients can prevent an unnecessary surgery due to non-localized disease. Preventing such surgeries ultimately eliminates post-operative morbidity and mortality as well. Grant FD, Fahey FH, Packard AB, et al. Skeletal PET with 18F-fluoride: applying new technology to an old tracer. J Nucl Med. 2008; 49:68-78. Yen RF, Chen CY, Cheng MF, et al. The diagnostic and prognostic effectiveness of F-18 sodium fluoride PET-CT in detecting bone metastases for hepatocellular carcinoma patients. Nucl Med Commun. 2010; 637-645. 2) Coregistration of computed tomography (CT) and PET bone findings permits the imager to be specific about the location and imaging characteristics of the lesion, whether benign or malignant. CT is not a part of the usual standard 99mTc planar bone scan, and even single-photon emission computerized tomography (SPECT) has lower resolution than PET/CT. Schirrmeister H, Guhlmann A, Elsner K, et al. Sensitivity in detecting osseous lesions depends on anatomic localization: planar bone scintigraphy versus 18F PET. J Nucl Med. 1999; 40:1623-1629. 3) The CT component of the PET/CT permits detection of enlarged lymph nodes, and pulmonary nodules that may also represent metastases. This CT evaluation is not part of a routine 99mTc planar bone scan. Coregistration with PET/CT can obviate the need for additional diagnostic CT evaluation, with its attendant additional radiation exposure. Even-Sapir E, Metser U, Flusser G, et al. Assessment of malignant skeletal disease: initial experience with 18F-fluoride PET/CT and comparison between 18F-fluoride PET and 18F-fluoride PET/CT. J Nucl Med. 2004; 45:272-278. Published Literature The clear diagnostic benefits of NaF-18 PET over conventional bone scintigraphy in detecting bone metastases are well described in an article by Poulsen et al. These authors found that (explanations added) “[s]ensitivity, specificity, positive and negative predictive values and accuracy were: WBS (99mTc-MDP whole body scan): 51, 82, 86, 43 and 61%; NaF-PET/CT: 93, 54, 82, 78 and 81%; and FCH-PET/CT (FCH: 18F-choline): 85, 91, 95, 75 and 87%, respectively.” Poulsen MH, Peterson H, Høilund-Carlsen PF, et al: Spine metastases in prostate cancer: comparison of technetium-99m-MDP whole-body bone scintigraphy, [18F]choline positron emission tomography (PET)/computed tomography (CT) and [18F]NaF PET/CT. BJU Int. 2014; 114:818-823. 99mTc Shortage & NaF-18 Option Although there are several alternative plans and technologies that have been proposed to attempt to achieve a sustained supply of 99mTc, it seems that there are still many hurdles to be overcome. Aqueous homogenous reactor-based technology, photo-fission, and target-fuel isotope reactor are innovative; however, the implementation of these technologies in routine production is still years away. The direct production of 99mTc via the use of a cyclotron may seem to be the most feasible and the most readily adaptable approach. However, the production yield of 99mTc, the competition in using the same cyclotron for supply of 99mTc and PET radioisotopes, and the long-hour utilization of the same cyclotron are some of the major concerns in adopting this approach for a routine operation. The primary goal of the American Medical Isotopes Production Act is to promote 99Mo production without the use of highly-enriched uranium (HEU). In order to ensure the success of adopting the low-enriched HEU (LEU)-based 99Mo production approach, the required qualities and quantity of 99mTc to meet the huge demand (in particular the U.S. market) must be adequately addressed. On the other hand, government subsidies and support of the research reactors in switching from HEU- to LEU-based production of 99Mo could be a major deterrent to those new vendors with new alternate technologies (especially when huge capital investment is involved). Regulatory aspect is another possible hindrance in the wide availability of these new technologies. Although the commercial success of these new production technologies depends on the FDA approval (in particular the market exclusivity if granted), the obtaining of these approvals is an expensive and time-consuming process. In addition to the current unstable supply network of 99Mo/99mTc, it seems that the uncertain future of the other alternate approaches further support the notion suggested by the NOPR Working Group for “the migration to NaF as an alternative method for radionuclide bone imaging.” In fact, we believe NaF-18 is a more reliable radiopharmaceutical for bone imaging. In summary, we strongly support CMS coverage for NaF-18 PET, and an end to the CED requirement, for NaF-18 PET for bone metastasis in cancer. Thank you for your consideration of this request. Less Commenter: Roarke, Michael Title: Consultant Diagnostic Radiology Organization: Mayo Clinic Date: 10/13/2015 Comment: Tamara Syrek Jensen, JD Director, Coverage and Analysis Group Centers for Medicare and Medicaid Services Dear Ms. Syrek Jensen: On behalf of Mayo Clinic we appreciate the opportunity to submit public comments to the Centers for Medicare & Medicaid Services (CMS) Proposed Decision Memo for Positron Emission Tomography (NaF-18) More
Djang, David	Title: MD Organization: Swedish Cancer Institute, Seattle WA Date: 10/16/2015 Comment: In our experience, the NaF-18 studies have been both more sensitive and more specific for detecting bone metastases than traditional Tc-99m MDP bone scans. Not only does this lead to more accurate diagnoses, it also requires fewer confirmation studies, often MRIs, to investigate the non-specific findings that are more often reported with the Tc99m MDP bone scans. These NaF-18 studies demonstrate significant clinic impact. More accurate, more confident results have resulted in a higher number of patients receiving more appropriate care, whether by switching therapies, or by better selecting patients who would be better served with palliative management. Last, it should be remembered that all NaF-18 is locally made on American soil. Most, if not all, Tc99m MDP utilized clinically has to be flown in from foreign nations. I have been in practice long enough to remember the week after 9/11/01, when most flights were shut down, and it was literally impossible for a patient to have a Tc99m MDP bone scan. Though obviously we will pray nothing ever happens again, this is a logistical reality that would be prudent to keep in mind when setting policy. Less In our experience, the NaF-18 studies have been both more sensitive and more specific for detecting bone metastases than traditional Tc-99m MDP bone scans. Not only does this lead to more accurate diagnoses, it also requires fewer confirmation studies, often MRIs, to investigate the non-specific findings that are more often reported with the Tc99m MDP bone scans. These NaF-18 studies demonstrate significant clinic impact. More accurate, more confident results have resulted in a More
Flynn, Thomas	Title: Chairman, National Policy Board Organization: The US Oncology Network Date: 10/16/2015 Comment: October 16, 2015 Tamara Syrek Jensen, J.D. Director, Coverage and Analysis Group Office of Clinical Standards and Quality Centers for Medicare & Medicaid Services 7500 Security Boulevard, Baltimore, MD 21244-1850 Via Online Submission RE: Comments on the Proposed Decision Memo for Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2) Dear Director Syrek Jensen: On behalf of the National Policy Board of The US Oncology Network, thank you for the opportunity to comment on the Proposed Decision Memo for Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2). This proposed decision memorandum is a result of the recent request of the National Oncologic PET Registry (NOPR) Working Group to end the prospective data collection requirements under coverage with evidence development (CED) for use of NaF-18 PET imaging for Medicare beneficiaries with bone metastases. The US Oncology Network is disappointed in the direction that CMS has taken with regards to the evidence submitted by the NOPR Working Group. We fully supported the requesters petition to end the prospective data collection requirements under CED for use of NaF-18 PET imaging, and therefore request that CMS reconsider this proposed decision. As background, The US Oncology Network (The Network) is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. Like-minded physicians are united through The Network around a common vision of expanding patient access to high-quality, integrated cancer care in communities throughout the nation. Leveraging healthcare information technology, shared best practices, refined evidence-based medicine guidelines, and quality measurements, physicians affiliated with The US Oncology Network are committed to advancing the quality, safety, and science of cancer care to improve patient outcomes. Since initiation of the NOPR NaF trial in 2011, The Network physicians have been active participants in this CED program and have come to recognize the distinct clinical advantages of this imaging modality over standard assessments for osseous metastatic disease, especially in difficult cases or in patients for whom subsequent clinical decisions carry the most weight – in terms of either clinical toxicities or expense of treatment. As stated by the initial requestors, the NOPR NaF trial has been successful in meeting the goals mutually set forth by the Centers for Medicare and Medicaid Services (CMS) and the NOPR Working Group at the inception of this trial. As a supplement to previously published data that clearly showed superior diagnostic accuracy of NaF PET imaging over routine bone scintigraphy with 99mTc-based diphosphonate compounds, the NaF NOPR results clearly demonstrated a very large clinical impact of this superior accuracy. There are relatively few single tests employed in advanced oncologic patient management that alter clinical decision-making in 40% of cases, as does NaF PET imaging. Therefore, The Network strongly urges CMS to reconsider this proposed decision memorandum and re-review the compelling data submitted by the NOPR and any additional data that was submitted to CMS as a result of the initial comment period. It is our contention that the submitted evidence demonstrates the value of NaF-18 PET imaging and its ability to accurately diagnose aggressive cancers that often require revised treatment planning to ensure appropriate care. Without this important diagnostic tool, cancer care providers are left at a disadvantage when planning the most effective, efficient and appropriate treatment in the most timely fashion – potentially resulting in poorer patient outcomes. Alternatively, providers could be forced to use inferior methods of determining the appropriate treatment through other modalities, which could likewise result in poor patient outcomes due to delayed or insufficient results. We also fully support the recently submitted comments to CMS on behalf of the NOPR Working Group. Specifically, we agree that: Coverage of NaF PET is clearly warranted by the available literature and the large amount of data gathered by the NOPR trial The data submitted by the NOPR Working Group are both sufficient for a positive coverage decision to be made at this time and clearly meet the scope and criteria for this trial that were mutually established with CMS Further documentation of impact on patient outcomes is both unnecessary and impractical in the case of NaF PET This tool should be available for appropriate use by referring physicians, without undue restrictions like further data collection in the NOPR system or arbitrary limitations on the number of such studies a patient should be allowed Additionally in the proposed decision memo, rather than removing the CED requirements, “CMS proposes to continue the requirement for coverage with evidence development (CED) under §1862(a)(1)(E) of the Social Security Act for NaF-18 PET to identify bone metastasis of cancer contained in section 220.6.19B of the Medicare National Coverage Determinations Manual for 12 months from the final date of this decision”. CMS further states that this extension is to allow further analyses and published evidence to “definitely answer” a set of questions – principally around patient management, quality of life and improved survival. Although we understand the rationale for this line of questioning, we have concerns that CMS is now seeking empirical evidence that directly links a diagnostic tool to outcomes in addition to improvements in patient management. We believe that a diagnostic tool allows for more appropriate care that could lead to improved patient outcomes, but the diagnostic tool cannot be measured in a silo. It should be understood and reiterated that patient management is the foundation of this analysis and evidence. In summary, The Network strongly disagrees with CMS’s decision to not end the prospective data collection requirements under CED for use of NaF PET. We believe that NaF PET offers sufficient clinical advantages, especially in relation to routine single-photon bone scintigraphy, and that it will provide both improved clinical management and decreased overall cost of care for oncology patients whose potential bone metastatic disease will be addressed more promptly and more appropriately. Thank you for the opportunity to comment on this proposed decision memorandum. Sincerely, Thomas P. Flynn, MD Chairman, National Policy Board The US Oncology Network Less October 16, 2015 Tamara Syrek Jensen, J.D. Director, Coverage and Analysis Group Office of Clinical Standards and Quality Centers for Medicare & Medicaid Services 7500 Security Boulevard, Baltimore, MD 21244-1850 Via Online Submission RE: Comments on the Proposed Decision Memo for Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2) Dear Director Syrek Jensen: On behalf of the National Policy More
Kennedy, Stephen	Title: MD Organization: St Anthony's Hospital Date: 10/16/2015 Comment: I have found NaF-18 to be very helpful in my practice. I am able to identify metastatic disease to the bone with greater certainty than traditional bone scintigraphy.
Bunning, Susan	Title: Director, Health Policy and Regulatory Affairs Organization: Society of Nuclear Medicine and Molecular Imaging Date: 10/16/2015 Comment: October 16, 2015 Tamara Syrek Jensen, Esq. Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services 7500 Security Blvd Baltimore, MD 21244 RE: Comments on Positron Emission Tomography (NaF-18) To Identify Bone Metastasis of Cancer (CAG-00065R) Proposed Decision Memorandum Dear Director Syrek Jensen: The Society of Nuclear Medicine and Molecular Imaging (SNMMI), the American College of Nuclear Medicine (ACNM) and the American College of Radiology (ACR) are pleased to provide the following comments on the Proposed Decision Memorandum on Positron Emission Tomography (NaF-18) (CAG-00065R). SNMMI is an international scientific and professional organization that promotes the science, technology and practical application of nuclear medicine. SNMMI’s more than 17,000 members set the standard for nuclear medicine and molecular imaging by creating guidelines, sharing information through journals and meetings, and leading advocacy on key issues. ACNM is a professional academy composed of physicians and other nuclear medicine professionals dedicated to enhancing the practice of nuclear medicine through the study, education and improvement of clinical practice. The organization is a strong advocate for nuclear medicine professionals and provides access to activities encompassing the business and socioeconomics of nuclear medicine before the legislative and regulatory bodies, other medical organizations, the media and the general public. ACR is a professional medical society dedicated to serving patients and society by empowering radiology professionals to advance the practice, science and professions of radiological care. The ACR represents over 36,000 members, drawn from radiologists, radiation oncologists, medical physicists, interventional radiologists, and nuclear medicine physicians. For over three quarters of a century, the ACR has devoted its resources to making imaging safe, effective and accessible to those who need it. SNMMI, ACNM, and ACR appreciate the opportunity to comment on the Proposed Decision Memorandum with regard to Positron Emission Tomography (NaF-18) to identify bone metastasis of Cancer. SNMMI, ACNM, and ACR disagree strongly with the proposed conclusion, that in this instance, the data available are affirmatively sufficient to determine that NaF PET is not a reasonable and necessary medical service. We share the NOPR Working Group position that the published and peer-reviewed research submitted as part of the NOPR reconsideration request, which analyzed NOPR data comprising 35,468 scans performed on 27,713 patients at 1,000 different PET facilities nationwide (data acquired in accordance with the NOPR study design and research protocol approved by CMS), is more than sufficient to demonstrate that NaF PET is reasonable and necessary, and warrants coverage for bone metastasis for all oncologic indications. In addition to the NOPR data on change of management, a recent study has shown that volumetric tumor burden estimated on a baseline NaF PET/CT is an independent predictor of patient outcomes - overall survival, progression free survival and skeletal related events, after treatment with 223Ra in hormone refractory prostate cancer patients. I. SNMMI, ACNM, ACR BELIEVE COVERAGE FOR NAF PET IS WARRANTED A. The Data Submitted are Sufficient for Coverage Consistent with CMS policy, the NOPR NaF registry undertook prospective data collection of the impact of NaF PET in patients with suspected or known osseous metastasis in any cancer type, using a CMS-approved questionnaire-based approach to assess referring physician–intended management. Structured information on NaF PET scan results was also collected from interpreting physicians. Additionally, the NOPR Working Group submitted three peer-reviewed manuscripts published in the Journal of Nuclear Medicine that summarized the NOPR NaF registry data and results. The first two manuscripts—one on findings in patients with prostate cancer and another on findings in patients with other cancer types (principally breast and lung) —were attached to NOPR’s May 2014 letter. The third manuscript, published in February 2015, assessed the impact of NaF PET on treatment monitoring of systemic cancer therapy for bone metastasis. The results reported in these three peer-reviewed publications demonstrated that there remains no clinical need to continue CED data collection for NaF PET for bone metastasis. As noted in the NOPR reconsideration request, the impact of NaF PET on intended management (classified as either treatment or non-treatment) before and after PET differed substantially between scans done for suspected first osseous metastasis (the most frequent indication) compared to either initial staging or suspected progression of osseous metastasis. In comparing management plans before and after NaF PET in patients receiving systemic therapy for metastatic cancer, four treatment-related options—continue, modify, switch or stop all therapy—were considered. The NaF PET registry also captured detailed categorization of the NaF PET findings from the interpreting physician. These data allowed a broad assessment of whether the differences in post-PET action by cancer types were appropriate in light of the scan findings. The overall post-NaF PET change in intended management was 40% (42% prostate, 39% breast and 35% all other cancers). After NaF PET, continuing current therapy was planned in 59%, switching therapy in 33%, modifying dose or schedule in 5% and stopping all therapy in 3%. Additionally, the referring physician judged the post-PET prognosis to be better than the pre-PET prognosis in 28% of instances, unchanged in 40% and worse in 32%. After NaF PET, continuing current therapy was planned in 81% of patients with a better or unchanged prognosis in contrast to those with a worse prognosis where 76% had plans to switch therapy. Among the 57% of patients with prior NaF PET scans for comparison, the plan when the new scan showed either no metastases, a reduction (improvement) in metastatic disease, or no change in metastatic disease was to continue current therapy in 82% of cases. However, when there was worsening or new osseous metastatic disease, the post-NaF PET plan was to switch therapies in 59%. We strongly believe that the published NOPR data provide evidence of the “changes in management due to test findings” that CMS seeks, and which the CMS-approved study design was intended to collect. The intended management data presented to CMS — and cited by CMS in the Proposed Decision — sufficiently demonstrate that diagnostic information obtained with NaF PET has an impact on physician thinking and formulation of patient management. Furthermore, while the Proposed Decision indicates that CMS desires additional “confirmatory analyses” to demonstrate that “actual change in management occurred” following NaF PET, SNMMI, ACNM, ACR, in agreement with NOPR, strongly believe that such a confirmatory study is entirely unnecessary. While NaF PET and FDG PET have distinct clinical purposes, the clinicians who perform and utilize NaF PET are by and large the same clinicians who perform and utilize FDG PET. There is no reason to believe that the difference in the diagnostic PET tracer used would have any impact upon the likelihood that the clinician would or would not implement the post-PET intended change in management reported to NOPR. B. Coverage Should Extend Beyond One Initial Scan The Proposed Decision suggests that while previous PET decisions (including FDG PET) had differentiated between initial and subsequent treatment, CMS “ha[s] not used this distinction for NaF-18 PET for bone metastasis of cancer since it applies more directly to early diagnostic evaluation than to advanced metastatic disease.” We are concerned that if CMS does cover NaF PET, coverage will be limited to one “initial scan” only. Doing so would not be consistent with clinical or with the current Medicare coverage of FDG PET, which CMS allows to be used for diagnostic evaluation of patients as part of subsequent management decision making (e.g., treatment monitoring, restaging after completion of treatment, detection of suspected recurrence), as well as for diagnosis and initial staging. We encourage CMS to clarify its position in this regard in its Final Decision. C. Coverage Should Include Both Oncologic and Limited Non-Oncologic Indications In addition to the data published on NaF PET in identifying bone metastasis of cancer, we strongly believe that the evidence indicates that NaF PET is equal or superior to the current covered technology of conventional BS for non-oncologic bone imaging purposes. Section IV of the reconsideration request focuses specifically on these non-oncologic benefits, and expressly requested that CMS “cover NaF PET for bone imaging across a spectrum of non-cancer/benign bone diseases, and favor authorizing local contractor discretion for the use of NaF PET across the broad universe of benign indications.” We were disappointed to note that in the Proposed Decision, CMS declined to address the coverage of non-oncologic uses of NaF PET at all. We continue to believe that NaF can be beneficial for certain limited non-oncologic indications, particularly those that cannot be imaged well with SPECT or SPECT-CT. II. FEASIBILITY OF A CONFIRMATORY STUDY CMS appears to indicate in the Proposed Decision that lifting the CED restrictions on NaF PET would be warranted if an additional study confirmed that the changes in intended patient management found by the NOPR were reflected in evidence of actual changes in patient management. We disagree strongly that confirmatory studies of the NOPR results as to the extent of actual change in management are required under the parameters of the CED study as approved by CMS. We also disagree strongly that the absence of such confirmatory studies precludes CMS from covering NaF PET, in light of the significant quantitative analysis demonstrating significant intended changes in patient management as a result of NaF PET. We believe that the use of oncologic NaF PET for both initial and subsequent treatment is consistent not only with clinical practice but also with the current Medicare coverage of FDG PET, which CMS allows to be used for diagnostic evaluation of patients as part of subsequent management decision making. We encourage CMS to clarify its position in this regard in its Final Decision. Finally, the proposed twelve month window is an exceptionally compressed time frame in which to accomplish this task proposed and avoid a coverage gap for Medicare beneficiaries. We share the NOPR Working Group belief that eighteen months from the Final Decision would be the minimum amount of time necessary for the researchers to obtain the necessary data, draft the requisite analysis, submit for publication, and complete the reconsideration process. We are concerned that a twelve month time limit could lead to a gap in coverage for Medicare beneficiaries, given the time needed for data analysis, submission for peer review publication, and the public comment periods required as part of the NCD reconsideration process. III. CONCLUSION SNMMI, ACNM, and ACR believe that the evidence-based conclusions from the NOPR analysis of the extensive NOPR NaF data set strongly support ending the CED data collection requirements. We strongly disagree with the conclusion of the Proposed Decision that the evidence is insufficient in this regard. We urge CMS to review the evidence in the light of the above comments, and to issue a Final Decision authorizing national coverage of NaF PET for bone metastasis for all oncologic indications. To the extent CMS declines to revisit its Proposed Decision and a confirmatory study is required, we believe that such study should be of limited scope and retrospective. We believe such a study could be based upon linking CMS claims data and NOPR data to determine the relationship between intended management and actual management. Such a study would require the assistance of CMS in expediting the provision of the necessary claims data, as well as a minimum of eighteen months between the date of the Final Decision and the expiration of CED coverage. Finally, we urge CMS strongly to reconsider the limited use of NaF PET for non-oncologic indications at the local contractor discretion, based on the position we have articulated above and in the original reconsideration request. Thank you, again, for allowing us to comment. We believe the NOPR data collection on NaF PET has conclusively demonstrated that NaF PET imaging is reasonable and necessary. In our day to day practice, we know it is necessary and is an invaluable tool in the care and treatment of patients. Sincerely, Hossein Jadvar, MD, PhD, MBA, MPH, FACNM SNMMI President Rathan Subramaniam, MD, PhD, MPH, FACNM ACNM President William T. Thorwarth, Jr., MD ACR Chief Executive Officer Less October 16, 2015 Tamara Syrek Jensen, Esq. Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services 7500 Security Blvd Baltimore, MD 21244 RE: Comments on Positron Emission Tomography (NaF-18) To Identify Bone Metastasis of Cancer (CAG-00065R) Proposed Decision Memorandum Dear Director Syrek Jensen: The Society of Nuclear Medicine and Molecular Imaging (SNMMI), the American College of Nuclear Medicine (ACNM) More
Wilf, Larry	Title: Nuclear radiologist Organization: 21st century oncology Date: 10/16/2015 Comment: Our group is a multispecialty oncology group which performs a substantial amount of PET/CT imaging. I am a tenured Associate Professor of Radiology at the University of Florida. Having performed gamma camera bone scan for over 20 years ..and now NaF18 BS since 2004, I can tell you without hesitation , there is no comparison. In my mind, performing a gamma camera BS in this day and age is malpractice. The PET scan sensitivity and resolution are beyond comparison and the added information ( anatomy / other findings elsewhere in the "body")from the scan are immeasureable. Less Our group is a multispecialty oncology group which performs a substantial amount of PET/CT imaging. I am a tenured Associate Professor of Radiology at the University of Florida. Having performed gamma camera bone scan for over 20 years ..and now NaF18 BS since 2004, I can tell you without hesitation , there is no comparison. In my mind, performing a gamma camera BS in this day and age is malpractice. The PET scan sensitivity and resolution are beyond comparison and the added information ( More
Doss, Mohan	Title: Associate Professor Organization: Fox Chase Cancer Center, Philadelphia, PA 19111 Date: 10/16/2015 Comment: Dear Colleagues, I have read the publications that have summarized results from 18F-NaF PET scans. There is indeed considerable evidence for the utility of these PET scans, as indicated by the change in treatment plan following the scans in a large fraction of the patients. I would urge you to reconsider your conclusion that there is not sufficient evidence for the use of NaF-18 PET scans to identify bone metastasis of cancer. Thank you for your consideration. Mohan Less Dear Colleagues, I have read the publications that have summarized results from 18F-NaF PET scans. There is indeed considerable evidence for the utility of these PET scans, as indicated by the change in treatment plan following the scans in a large fraction of the patients. I would urge you to reconsider your conclusion that there is not sufficient evidence for the use of NaF-18 PET scans to identify bone metastasis of cancer. Thank you for your More
Singh, Amolak	Title: Professor, Chief and Chairman Organization: Nuclear Medicine, University of MO-Columbia Date: 10/16/2015 Comment: Bone scans with F-18 NAF are so much better that it will replace Tc-99 m Bone scans which are insensitive and often miss cancer and as well benign pathology. It is disservice to patients to use inferior method of bone scanning when far better method for bone scanning is available. Please approve this ASAP.
Krynyckyi, Borys	Title: MD Organization: PCMI Date: 10/16/2015 Comment: We have been using NAF PET bone scans since 2008, they have been remarkably useful, especially when compared to simple suboptimal planar bone scans. The combination of superior 3-D resolution on the emission portion, coupled to the simultaneously acquired CT, has provided clinicians much useful data. In our community conventional planar bone scans with MDP are only 50% accurate!! Using NAF PET scans, we are able to routinely identify arthritis/degenerative findings much more accurately than simple planar bone scans; we are able to routinely identify traumatic findings much more accurately than simple planar bone scans; we are able to routinely identify malignant findings much more accurately than simple planar bone scans. In addition, review of CTs often can detect malignancy in the form of pulmonary nodules, abdominal pelvic nodes/masses amongst other findings typically seen on CT; i.e. with the NAF PET bone scan you are also getting a CT of the entire body to search for disease/abnormalities. Denying approval for NAF PET bone scans is unimaginable; would you suddenly consider dropping 128 slice CT studies and replace them with simple chest x-rays? Sounds ridiculous, but that is exactly what you are proposing by dropping NAF PET studies and allowing simple planar bone scans. The more logical decision would be to drops simple planar bone scans and replace them with NAF PET studies for all indications, as they are much, much more accurate. With an accuracy of only 50%, simple planar bone scans often mislead the clinician as to what disease process exists, or does not exist. They often generate more questions than they answer, often get the medical question asked wrong, and often require unnecessary additional tests or even unnecessary biopsies… Bone scanning has undergone a paradigm shift with the availability of NAF PET bone scans; regression into the dark ages is unthinkable... Sincerely, Borys R. Krynyckyi, MD PCMI Less We have been using NAF PET bone scans since 2008, they have been remarkably useful, especially when compared to simple suboptimal planar bone scans. The combination of superior 3-D resolution on the emission portion, coupled to the simultaneously acquired CT, has provided clinicians much useful data. In our community conventional planar bone scans with MDP are only 50% accurate!! Using NAF PET scans, we are able to routinely identify arthritis/degenerative More
Wilson, Terri	Title: Director, Molecular Imaging & PET Organization: Medical Imaging & Technology Alliance Date: 10/16/2015 Comment: Tamara Syrek Jensen, Esq. Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Re: Comments on Proposed Decision Memorandum (CAG-00065R2) Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer Dear Director Syrek Jensen: The Medical Imaging & Technology Alliance (MITA) appreciates this opportunity to submit comments to express its serious concerns with the referenced proposed decision memorandum on the Centers for Medicare & Medicaid Services (CMS) National Coverage Determination (NCD) Section 220.6.19B. MITA contends that the published registry and other evidence submitted by the National Oncologic PET Registry (NOPR) Working Group in its reconsideration request for this coverage with evidence development (CED) decision is more than sufficient. It clearly shows the important benefits of NaF-18 positron emission tomography (NaF PET) scans in managing Medicare beneficiaries with bone metastases, and to support coverage without the data collection prerequisite. MITA therefore believes CMS should not finalize its proposed decision and instead: Remove the requirement for prospective data collection for coverage of NaF PET for oncologic indications; and Delegate to the local Medicare Administrative Contractors (MACs) the determination of coverage for non-oncologic indications. This approach would be similar to the one taken by CMS in its recent reconsideration of the CED for fluorodeoxyglucose positron emission tomography (FDG PET) for oncologic indications. If CMS declines to remove the data requirements and extend coverage – an outcome we would have difficulty understanding – we urge the agency to continue the CED until such time as the additional evidence sought by CMS can be reviewed and submitted for publication. Whereas CMS suggests a 12-month period would be sufficient to allow a confirmatory analysis of changes in patient management, MITA believes the continuation of the current CED for a more realistic time period of no fewer than eighteen months be applied. Only in this way can appropriate beneficiary access to an important diagnostic tool be preserved. About MITA MITA is the leading industry association representing medical imaging, radiation therapy, and radiopharmaceutical manufacturers. We have a long-standing and documented history of supporting appropriate use of these technologies for the early detection, diagnosis, staging, therapy monitoring, and surveillance of many diseases including oncology, neurology and cardiology applications of PET imaging and most recently low-dose CT for lung cancer screening. Because the proposed decision, if finalized, would eliminate an appropriate use for appropriate patients, MITA members strongly urge CMS to revisit the submitted data along with any additional data, and not finalize its proposed decision. MITA Comments I. EVIDENCE ON NAF-18 PET SCANS TO IDENTIFY BONE METASTASIS OF CANCER MEETS THE MEDICARE REASONABLE AND NECESSARY UNDER § 1862(A)(1)(A) A. Improved Patient Management Section 1862(a)(1)(A) of the Social Security Act articulates the standard for withholding coverage if a diagnostic test is “not reasonable and necessary to diagnose . . . an illness or injury.” The proposed decision memo concludes that the appropriate measure of whether NaF PET is “reasonable and necessary” for purposes of meeting the § 1862(a)(1)(A) standard is whether it “affects health outcomes through changes in disease management brought about by physician actions taken in response to test results.” The proposed decision memo goes on to state that “[s]uch actions may include decisions to treat or withhold treatment, to choose one treatment modality over another, or to choose a different dose or duration of the treatment.” We believe this is precisely what the NOPR data show. The current CED for NaF-18 Positron Emission Tomography (NaF PET) was developed “to inform the initial antitumor treatment strategy or to guide subsequent antitumor treatment strategy after completion of the initial treatment.” In the proposed decision memo, CMS states that to evaluate whether continued collection was needed, the agency evaluated the presented data and other published evidence for “evidence demonstrating how the treating physician uses the result of a NaF-18 PET imaging test for cancer metastasis to bone in whom bone metastases are strongly suspected based on clinical symptoms or the results of other diagnostic studies.” The published studies on the NOPR data address the treating physicians’ uses of the diagnostic information in disease management. Since its inception in 2011, the NOPR NaF PET Registry has collected data for over 27,000 patients at 1,000 different PET facilities nationwide. Peer-reviewed published studies address the registry data, which include comparisons of management plans before and after NaF PET were performed on patients receiving systemic therapy for metastatic cancer. , , This included evaluations of options “to treat or withhold treatment” or “to choose a different dose or duration of treatment” by continuing, modifying, switching or stopping all therapy. One published article reported on the analysis set of 2,217 of the patients 65 years or older receiving systemic therapy, such as chemotherapy or immunotherapy. The study’s 2,839 scans had an overall post-NaF PET change in intended management of 40% (42% for prostate, 39% for breast and 35% for all other cancers). Not only were the treating physicians able to use the information to plan a continuation of current therapy, a switching of therapy, modification of doses or schedule and stopping all therapy, but additionally, the referring physician judged the post-PET prognosis to be better, worse or unchanged from the pre-PET prognosis. MITA believes the published NOPR data provide evidence that CMS seeks on the changes in management due to test findings. Nonetheless, CMS has rejected this data and requested confirmatory analysis, finding that the data provided by NOPR and others only reported on intended management changes, but did not “confirm that actual change in management occurred.” This standard is inconsistent with CMS’s articulated standard for reconsidering the CED for Fluorodeoxyglucose (FDG) PET for solid tumors. There, CMS was presented with similar evidence that the FDG PET had a significant effect on the “intended treatment” of various solid tumors, but nonetheless concluded that the information was sufficient to “support[ ] the use of FDG PET as reasonable and necessary in the management” of those tumors. For example, CMS found that the FDG PET had a “larger effect on intended treatment” for those with primary brain tumors than those in the overall registry population, and found this evidence sufficient to conclude the use of the FDG PET as reasonable and necessary for the management of recurrent primary brain tumors. Similarly, CMS found that physicians managing treatment of patients with prostate cancer “would change their intended therapy” in about 40% of instances after use of the FDG PET. MITA therefore requests that CMS similarly end CED for NaF-18 PET and cover the NaF-18 PET under §1862(a)(1)(A). B. Identifies Bone Metastasis of Cancer More Precisely than Alternative Tests Physicians participating in the NOPR study indicate that without the NaF PET, other interventions would be used. Indeed, these tests have some clinical disadvantages, yet are covered without the barrier of a CED. The clinical data for prostate cancer cases show that the NaF technology may be more advantageous than alternative bone scanning (using Tc-99 diphophonates) because of its superior image quality, and because it emits a lower radiation dose. NaF PET has been shown to provide higher sensitivity and specificity than bone scintigraphy for the detection of osseous metastases in men with prostate cancer. In addition to these advantages, Medicare beneficiaries across the country now are able to access this important technology because the infrastructure of cyclotrons and PET scanners is sufficient to reach all areas of the country. II. MITA URGES CMS TO CONTINUE CED COVERAGE DURING ANY FURTHER DATA GATHERING AND REVIEWS CMS covers NaF PET scans to identify bone metastasis of cancer when the service is performed through the CMS-approved registry, with a CMS-approved protocol. Over 1000 facilities have participated so far in the NaF PET study. CMS now requests additional analysis to answer the following question: “Does the addition of NaF-18 PET imaging lead to: a change in patient management to more appropriate palliative care; a change in patient management to more appropriate curative care; improved quality of life; or improved survival? To allow confirmatory evidence to be performed, CMS proposes to continue the requirement for CED under Section 1862(a)(1)(E) for 12 months after CMS’s final decision on this reconsideration. To the extent CMS’s final decision does not continue coverage for NaF PET, MITA has serious concerns that 12 months will provide insufficient time for collection, analysis and publication of confirmatory data requested by CMS. A minimum of 18 months from the final decision is needed to obtain the necessary data, draft the requisite analysis, submit for publication, and complete the new reconsideration process. Moreover, we understand that conducting such a study will depend to a large degree on the ability to obtain expedited access to the requisite Medicare claims data. This would most likely lead to a gap in coverage for Medicare beneficiaries with devastating diagnoses. MITA therefore encourages extension of the CED for a minimum of 18 months from the date the final decision. Moreover, this extension is consistent with CMS’s CED guidance. CMS’s most recent CED Guidance document notes that a CED cycle is only considered completed when “CMS completes a reconsideration of the CED coverage decision, and removes the requirement for study participation as a condition of coverage.” Because CMS has requested further confirmatory analysis, and because such analysis will require further data gathering through extended study participation, CMS may extend the CED for longer than 12 months. MITA encourages and supports continuing the current CED so as to avoid a coverage gap for Medicare beneficiaries. MITA has and continues to support the NOPR Working Group’s efforts to end the data collection requirements under CED for oncologic indications using NaF PET. We believe the clinical evidence more than adequately shows the benefits of patient management with NaF PET. For the reasons stated, we therefore urge CMS to re-evaluate the evidence and revise the current CED to extend coverage for initial and subsequent imaging for oncologic indications. We also support the reconsideration request to allow Medicare Administrative Contractor discretion for non-oncologic indications to evaluate benign bone disease using NaF PET imaging. This would be consistent with the approach taken by CMS for FDG PET. To the extent the agency declines to remove the CED data requirements, we urge CMS to continue coverage under the CED until such time as additional evidence can be collected and reviewed, and the third reconsideration process can be completed, a period of no fewer than eighteen months. * * * * MITA would be pleased to answer any questions you might have about these comments or if we can be of further assistance. Please do not hesitate to contact me at (703) 841-3258. Sincerely, /s/ Terri Wilson, MBA, BS, CNMT Director, Molecular Imaging & PET, MITA Less Tamara Syrek Jensen, Esq. Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Re: Comments on Proposed Decision Memorandum (CAG-00065R2) Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer Dear Director Syrek Jensen: The Medical Imaging & Technology Alliance (MITA) appreciates this opportunity to submit More
Contag, PhD, Christopher H.	Title: President Organization: World Molecular Imaging Society Date: 10/15/2015 Comment: Dear Director Syrek Jensen: The World Molecular Imaging Society (WMIS) appreciates the opportunity to comment on the Proposed Decision Memorandum on Positron Emission Tomography (NaF-18) (CAG-00065R). We were disappointed to learn that the Centers for Medicare & Medicaid Services (CMS) proposes to find that the data is insufficient to determine that NaF PET is reasonable and necessary for the identification of bone metastatis of cancer, and further proposes to continue Coverage with Evidence Development (CED) for NaF PET in order to enable additional confirmatory research to be conducted. WMIS strongly opposes the conclusion of the Proposed Decision, as we believe that the data submitted by the National Oncologic PET Registry (NOPR) Working Group are sufficient to demonstrate that coverage of NaF PET for the designated oncologic indications is both reasonable and necessary. We encourage CMS to review the submitted data and publications once again, and issue a Final Decision that ends the CED restrictions on NaF PET and authorizes national coverage. In so doing, WMIS further encourages CMS to clarify that coverage will extend to more than merely the initial NaF PET scan, as is the case with Medicare coverage for oncologic FDG PET. Should CMS nonetheless insist upon additional confirmatory research, WMIS strongly advises CMS to consider extending the proposed twelve month deadline for completion of such research before CED is terminated. We believe that a minimum of eighteen months would be necessary for such research. The practical and logistical requirements involved in completing a peer-reviewed study of this scope and focus should not operate to deprive Medicare beneficiaries of the availability of NaF PET under CED. WMIS Background WMIS is an international scientific educational organization dedicated, in significant part, to the utilization of quantitative molecular imaging in patient care. At present, WMIS has over 1,000 members. The foremost and authoritative society in molecular imaging, WMIS was formed in 2011 from the merger of two of the premier molecular imaging societies — the Academy of Molecular Imaging and the Society for Molecular-Genetic Imaging. Between 2006 and 2011, AMI was the sponsor of the original National Oncologic PET Registry (NOPR). Post-merger, WMIS continued to sponsor NOPR 2009 through its conclusion, and continues to sponsor NOPR (NaF-PET). The Reconsideration Request Data Are Sufficient for Coverage As the sponsor of NOPR NaF-PET, WMIS was actively engaged with both the NOPR Working Group and with CMS staff in developing the CMS-approved study design for the NOPR NaF PET CED study. As CMS is aware, the multi-site registry-based CED approach that was successfully utilized for FDG PET was replicated for NaF PET, and generated an extensive data set for analysis. Pursuant to the CMS-approved study design, NOPR NaF PET collected data comprising 35,468 scans performed on 27,713 patients at 1,000 different PET facilities nationwide over a four-year period. Per the CMS-approved study protocol, the objective of the NOPR NaF PET CED study was to “assess the effect of NaF-PET on referring physicians’ plans of intended management of patients with known or suspected bone metastases participating in NOPR (NaF-PET).” As detailed in the NOPR Working Group reconsideration request, the accumulated NOPR NaF registry data yielded three peer-reviewed published manuscripts summarizing the results. The Working Group contends — and WMIS concurs — that these manuscripts together provide what CMS states in its Proposed Decision that it was seeking: “evidence demonstrating how the treating physician uses the result of a NaF-18 PET imaging test for cancer metastasis to bone in whom bone metastases are strongly suspected based on clinical symptoms or the results of other diagnostic studies.” For instance, the NOPR Working Group reported that the overall post-NaF PET change in intended management was 40% (42% prostate, 39% breast and 35% all other cancers) — a clear indication that the additional information provided by NaF PET influenced how the treating physician chose to manage patient care. Indeed, after NaF PET, while continuing current therapy was planned in 59% of cases, switching therapy was planned in 33%, with modifying dose or schedule in 5% and stopping all therapy in 3%. The data also demonstrate that NaF PET provided added value to the referring physicians in terms of patient management, as those physicians judged post-PET prognosis to be better than the pre-PET prognosis in 28% of instances, unchanged in 40% and worse in 32%. Furthermore, WMIS strongly emphasizes that it does not believe that additional confirmatory evidence is necessary for CMS to issue a favorable coverage determination for NaF PET. While the desire for additional confirmatory evidence is understandable in the abstract (and is certainly necessary in certain situations), WMIS believes that the effort required to obtain the specific confirmatory evidence being requested by CMS here is disproportionately onerous to any marginal benefit that would be generated from such efforts. WMIS contends that there is little if any reason to believe that clinicians who report their intended use of imaging results are somehow disproportionately likely to disregard that same stated intent in actual practice, absent an intervening change in patient condition that is unrelated to the results of the imaging. Indeed, CMS did not require evidence confirming actual implementation of intended use prior to removing the CED restrictions on FDG PET, and there is no practical distinction between FDG PET and NaF PET in this respect. Overall, WMIS believes that the NOPR data and publications convincingly demonstrate the value of NaF PET as a diagnostic tool that meets the criteria for ending the CED requirements as established by CMS: affecting “health outcomes through changes in disease management brought about by physician actions taken in response to test results.” We encourage CMS to issue a Final Decision Memorandum that ends the CED requirements on the basis of the existing data, and provides national coverage for NaF PET for oncologic indications. CMS Should Confirm Coverage for Multiple Scans Throughout its long sponsorship of the NOPR, first with FDG PET and now with NaF PET, WMIS and its predecessors have recognized the clinical importance of ensuring the availability of PET imaging not only for initial treatment strategy, but subsequent treatment strategy as well. The use of imaging for both initial and subsequent treatment strategy reflects standard clinical practice in oncology, as CMS accurately acknowledged in the Proposed Decision. This standard clinical practice also informed our belief as to the importance of ensuring that coverage of oncologic FDG PET extended beyond initial treatment, and why (as the NOPR’s sponsor) we believed it important that the NOPR NaF PET CED parameters permitted for “prospective data collection used in initial anti-tumor treatment strategy and/or subsequent anti-tumor treatment strategy for NaF-18 PET in identifying bone metastases . . . .” Given that CMS confirms in the Proposed Decision that imaging to detect bone metastases “is also recommended when a patient, following completion of initial treatment, is symptomatic with bone pain suspicious for metastases from a known primary tumor,” WMIS was thus perplexed by the assertion that while CMS differentiated between initial and subsequent treatment strategy for oncologic FDG PET, CMS “ha[s] not used this distinction for NaF-18 PET for bone metastasis of cancer since it applies more directly to early diagnostic evaluation than to advanced metastatic disease.” Given prior precedent and CMS’s own recognition of standard clinical practice, we presume CMS does not mean to imply by the latter statement that any post-CED coverage of NaF PET would be restricted to a single initial scan. WMIS encourages CMS to confirm in its Final Decision that coverage for NaF PET, whether under CED or generally, reflects prevailing clinical standards and extends to scans for both initial and subsequent treatment strategy. Twelve Months is Insufficient for the Requested Confirmatory Study WMIS observes that that CMS has proposed to extend CED for a period of twelve months for the the purpose of allowing “confirmatory analyses to be performed and resulting evidence to be published” on the question of whether the intended management reported by clinicians following NaF PET is reflected in actual patient management. As explained above, WMIS believes that the existing data are sufficient to justify coverage of NaF PET now. However, if CMS elects to finalize the recommendation in the Proposed Decision, WMIS is concerned that twelve months is simply an insufficient amount of time. While WMIS does not express any opinion as to the form that any confirmatory analysis should take, WMIS believes that it is unreasonable to expect that a study of the necessary scope and scale — requiring the development of a study design and associated protocols, data collection and aggregation, data analysis, drafting, peer-review, and publication — could be accomplished within such a limited period. Nor are certain aspects of the process — notably peer review and publication — within the control of the study authors, regardless of the speed with which those authors are able to collect and analyze the relevant data. Nor is the length of the CED extension of merely academic concern. Given that the failure of such a study to be completed, reviewed, and published within twelve months would have significant practical consequences — the denial of NaF PET coverage to Medicare beneficiaries — WMIS urges CMS to extend CED for a period of time that is more attuned with the practical realities of conducting the research that CMS believes is necessary. We believe that at minimum, a period of eighteen months would be appropriate for this purpose. Conclusion WMIS appreciates this opportunity to provide CMS with comments in an area of significant WMIS expertise and experience, and would be pleased to provide CMS with any additional information that CMS may find useful in reaching its final decision. Sincerely, Christopher H. Contag, PhD President, World Molecular Imaging Society Professor, Departments of Pediatrics, Microbiology & Immunology, and Radiology Assoc. Chief, Neonatology Co-director, Molecular Imaging Program Stanford University School of Medicine Less Dear Director Syrek Jensen: The World Molecular Imaging Society (WMIS) appreciates the opportunity to comment on the Proposed Decision Memorandum on Positron Emission Tomography (NaF-18) (CAG-00065R). We were disappointed to learn that the Centers for Medicare & Medicaid Services (CMS) proposes to find that the data is insufficient to determine that NaF PET is reasonable and necessary for the identification of bone metastatis of cancer, and further proposes to continue Coverage More
Yoskin, Maruice	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Weyn, David	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Serafain, Anton	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Schwartzberg, Marc	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Paymani, Mahrad	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Patel, Romil	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
McMullen, Laird	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Liu, Yi	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Levine, Michael	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Keller, Cathrine	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Kainz, George	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Houston, Steve	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Hira, Ajay	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Held, Richard	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Hameedi, Amir	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Gurinsky, Joseph	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Diaz, Rosendo	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Chang, Pairoj	Title: Dr Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Carroll, J. Scott	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Bhatia, Manoj	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Bajayo, David	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Anderson, Jon	Title: Dr. Organization: Lake Medical Imaging Date: 10/15/2015 Comment: Lake Medical Imaging radiologists disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management.
Hillner, Bruce	Title: Chair Organization: NOPR Working Group Date: 10/14/2015 Comment: On behalf of the National Oncologic PET Registry (NOPR) Working Group, we are pleased to provide these comments on the Proposed Decision Memorandum on Positron Emission Tomography (NaF-18) (CAG-00065R2).[1] The NOPR Working Group appreciates and values its long and continued collaboration with the Centers for Medicare & Medicaid Services (CMS) in utilizing Coverage with Evidence Development (CED) to develop data-driven bases for the reasonable and necessary coverage of various forms of PET for oncologic indications. As CMS is aware, these coverage decisions have benefitted thousands of Medicare beneficiaries over the past decade, and continue to do so today. However, the NOPR Working Group disagrees strongly with the proposed conclusion that, in this instance, the data available are “sufficient to determine that use of a NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer is not reasonable and necessary to diagnose or treat an illness.”[2] It is our position that the published and peer-reviewed research submitted as part of our reconsideration request, which analyzed NOPR data comprising 35,468 scans performed on 27,713 patients at 1,000 different PET facilities nationwide (data acquired in accordance with the NOPR study design and research protocol approved by CMS), is more than sufficient to demonstrate that NaF PET is reasonable and necessary, and warrants coverage for bone metastasis for all oncologic indications. We recognize that CMS has proposed to continue CED for NaF PET in order to allow for confirmatory analyses to be performed and published that would assess whether pre-PET to post-PET changes in intended management were reflected in actual patient management. To the extent that CMS continues to believe (after again reviewing the publications and data submitted as part of the reconsideration request) that this question has not already been sufficiently addressed, it is possible that a confirmatory study using CMS claims data could be conducted to answer this question. Particularly given the exceptionally compressed proposed timeline of twelve months for such a study, the NOPR Working Group envisions a retrospective analysis that maps CMS claims data against the corresponding NOPR data to address this question. Completing a confirmatory study within these parameters would be dependent on being able to obtain expedited access to the requisite claims data for the consented NOPR cohort. I. NOPR Believes Coverage of NaF PET is Warranted There has been extensive NOPR data collection on NaF PET since 2011, pursuant to the detailed CED study design that was drafted in collaboration with and approved by CMS for precisely this purpose. Per Section 220.6.19 of the Medicare Manual, before a NaF PET CED study can be approved by CMS, proponents must (among other things) demonstrate to the satisfaction of CMS that “the research study design is appropriate to answer the research question being asked in the study.” The NOPR NaF PET study was approved by CMS, and the NOPR Working Group has now published data (consistent with the approved study design) that demonstrates that NaF PET is reasonable and necessary for the Medicare beneficiary population. Where the data submitted are consonant with the study parameters as approved by CMS, and given the results thereof, we believe these data are sufficient to justify coverage without the need for additional research. A. The Data Submitted are Sufficient for Coverage Consistent with CMS policy, the NOPR NaF registry undertook prospective data collection of the impact of NaF PET in patients with suspected or known osseous metastasis in any cancer type, using a CMS-approved questionnaire-based approach to assess referring physician–intended management before and after NaF PET. Structured information on NaF PET scan results was also collected from interpreting physicians. Through December 31, 2014, the NaF PET registry had collected data from 35,468 scans performed on 27,713 patients at 1,000 different PET facilities nationwide. The monthly average number of completed scans was 564 in 2011, 720 in 2012, 843 in 2013, and 909 in 2014. In support of our reconsideration request, the NOPR Working Group submitted three peer-reviewed manuscripts published in the Journal of Nuclear Medicine that summarized the NOPR NaF registry data and results. The first two manuscripts—one on our findings in patients with prostate cancer[3] and another on our findings in patients with other cancer types (principally breast and lung)[4]—were attached to our May 2014 letter. The third manuscript, published in February 2015 (and attached to our updated February 2015 letter), assessed the impact of NaF PET on treatment monitoring of systemic cancer therapy for bone metastasis.[5] The results reported in these three peer-reviewed publications, and discussed in detail in our reconsideration request, demonstrated that there remains no clinical need to continue CED data collection for NaF PET for bone metastasis.[6] The Proposed Decision states that CMS evaluated the NOPR data and other published evidence on the basis of whether there was “evidence demonstrating how the treating physician uses the result of a NaF-18 PET imaging test for cancer metastasis to bone in whom bone metastases are strongly suspected based on clinical symptoms or the results of other diagnostic studies.”[7] We agree with CMS that the appropriate standard is not whether NaF PET demonstrates a change in health outcomes, since “[a]s a diagnostic test, NaF-18 PET would not be expected to directly change health outcomes.”[8] And we agree with CMS that the appropriate measure of whether NaF PET is reasonable and necessary is whether it “affects health outcomes through changes in disease management brought about by physician actions taken in response to test results.”[9] We believe that this is precisely what the NOPR data showed. As noted in our reconsideration request, the impact of NaF PET on intended management (classified as either treatment or non-treatment) before and after PET differed substantially between scans done for suspected first osseous metastasis (the most frequent indication) compared to either initial staging or suspected progression of osseous metastasis. In comparing management plans before and after NaF PET in patients receiving systemic therapy for metastatic cancer, four treatment-related options—continue, modify, switch or stop all therapy—were considered. The NaF PET registry also captured detailed categorization of the NaF PET findings from the interpreting physician. These data allowed a broad assessment of whether the differences in post-PET action by cancer types were appropriate in light of the scan findings. The overall post-NaF PET change in intended management was 40% (42% prostate, 39% breast and 35% all other cancers). After NaF PET, continuing current therapy was planned in 59%, switching therapy in 33%, modifying dose or schedule in 5% and stopping all therapy in 3%. Additionally, the referring physician judged the post-PET prognosis to be better than the pre-PET prognosis in 28% of instances, unchanged in 40% and worse in 32%. After NaF PET, continuing current therapy was planned in 81% of patients with a better or unchanged prognosis in contrast to those with a worse prognosis where 76% had plans to switch therapy. Among the 57% of patients with prior NaF PET scans for comparison, the plan when the new scan showed either no metastases, a reduction (improvement) in metastatic disease, or no change in metastatic disease was to continue current therapy in 82% of cases. However, when there was worsening or new osseous metastatic disease, the post-NaF PET plan was to switch therapies in 59%. The Proposed Decision included a review of recent peer-reviewed publications, and CMS raised several specific criticisms of meta-analyses evaluating the performance of NaF PET. * “While PET/CT (NaF-18 and FDG) can detect bone metastases of cancer, it is unclear why BS alone was used as the comparator to a combination of PET and CT. It does not seem to be balanced to compare 2 tests, PET and CT, to one test, BS.”[10] The comparison is valid and appropriate because conventional planar bone scintigraphy is the current standard of care. When interpreted without benefit of comparison radiographs or recently obtained CT or MRI, the specificity of the test is limited by the many benign processes (especially degenerative joint disease) giving rise to focally increased tracer uptake that is frequently not distinguishable from metastatic disease. If other imaging has not already been obtained, it frequently must be done and compared with the bone scintigraphy to assess whether areas of focal uptake are likely benign or malignant. With NaF PET/CT, the hybrid imaging approach means that the necessary morphologic information is provided in a single examination and is fused with the functional information make one-to-one assessment of anatomy and physiology for each focus far easier than it is with side-by-side comparison. There is no question that NaF PET is more sensitive than conventional bone scintigraphy whether it is performed with PET alone, as shown in the early work by Schirrmeister and colleagues,[11] or with PET/CT, as shown in the recent meta-analyses discussed in the proposed decision. Although the concurrent CT obtained with NaF PET/CT may detect some lesions not recognized on the NaF images, it also detects lesions, especially sclerotic foci in men with prostate cancer, that are no longer metabolically active. Again the ability to perform a one-to-one evaluation of each lesion in a fused data set is an invaluable aid to accurate interpretation of the study. Conventional bone scintigraphy is often supplemented by SPECT or, increasingly, by SPECT/CT facilitating a detailed evaluation of symptomatic regions or of abnormalities seen on planar bone scintigraphy. SPECT has improved sensitivity by comparison with planar scintigraphy and the CT information with SPECT/CT allows for greater specificity (as is the case with NaF PET). However, whole-body SPECT or SPECT/CT to match the NaF PET/CT examination in extent is not practical with current scanners; such an examination would require at least an hour of imaging versus approximately 15 minutes for whole-body NaF PET/CT. * “In addition, the radiation exposure from combined PET/CT is a concern . . . compared with BS planar or BS planar and SPECT.” [12] The effective dose with NaF for an administered adult dosage of 7.5 mCi (the midpoint of the 5-10 mCi recommended dosage) is 0.67 rem. This is only slightly higher than the 0.52 rem effective dose with Tc-99m MDP for an administered adult dosage of 25 mCi (the midpoint of the 20-30 mCi recommended dosage). The CT component of NaF PET/CT clearly increases the radiation exposure from the test, but with modern low-dose CT technique, effective doses of 0.3 rem are readily achievable.[13] As noted above, many patients who undergo conventional bone scintigraphy subsequently need additional radiographic or CT evaluation for comparison with the bone scan. Also, many patients undergo chest, abdomen and pelvis CT with higher-dose technique on the same day as or in close proximity to the bone scan. These considerations minimize the impact of the apparent dose disadvantage. Furthermore, the stochastic risk of the additional radiation exposure in Medicare beneficiaries with proven or strongly suspected cancer is small. * “PET may have similar limitations in false positive results from reactive processes other than bone metastases of cancer. False positives may lead to additional diagnostic tests which in turn may have associated benefits and/or harms. False negatives may lead to incorrect prognosis and planning and other harms. It is unclear whether or not benefits and/or harms of subsequent testing and evaluation after PET scans were considered.”[14] Although limitations related to potential false-positive and false-negative results and their respective impact on patient management and outcomes surely apply to NaF PET, as they do to every diagnostic imaging test, there is no evidence to suggest that these are likely to be of greater concern with NaF PET than with conventional bone scintigraphy. In fact, this reasoning is counterintuitive given the abundantly documented superior image quality and higher sensitivity and specificity of NaF PET/CT. As demonstrated in the reconsideration request and reiterated above, we strongly believe that the published NOPR data provide evidence of the “changes in management due to test findings” that CMS seeks, and which the CMS-approved study design was intended to collect.[15] The intended management data presented to CMS—and cited by CMS in the Proposed Decision—sufficiently demonstrate that diagnostic information obtained with NaF PET has an impact on physician thinking and formulation of patient management. Furthermore, while the Proposed Decision indicates that CMS desires additional “confirmatory analyses” to demonstrate that “actual change in management occurred” following NaF PET, the NOPR Working Group strongly believes that such a confirmatory study is entirely unnecessary. In particular, we would remind CMS that, in subsequent work with FDG PET registry data, the NOPR Working Group did use data linkage between NOPR identifiers and Medicare claims to evaluate the concordance of planned and actual actions. That research concluded that Medicare claims confirmed NOPR FDG PET intended management indications (positive predictive value) for single-mode systemic therapy in 62.0% of patients, radiation in 66.0% of patients, surgery in 45.6% of patients, and biopsy in 55.7% of patients.[16] Crucially, while NaF PET and FDG PET have distinct clinical purposes, the clinicians who perform and utilize NaF PET—and who report their “intended management” as a result—are by and large the same clinicians who perform and utilize FDG PET. There is no reason to believe that the difference in the diagnostic PET tracer used would have any impact upon the likelihood that the clinician would or would not implement the post-PET intended change in management reported to NOPR. In sum, we believe that the existing data are consonant with both CMS’s own evaluation criteria and the scope of the approved CED study, and are sufficient to warrant coverage. B. The Scope and Protocols of the CMS-Approved NOPR NaF PET CED Study Were Sufficient to Develop the Data Necessary for Coverage While we believe that the published NOPR data are sufficient to warrant coverage for NaF PET, we also think it valuable to reiterate precisely what the CMS-approved NOPR NaF PET CED study was and was not expected to demonstrate. First, the sole primary objective of the CMS-approved NOPR NaF PET CED study was, as stated in the study protocol, to “assess the effect of NaF-PET on referring physicians’ plans of intended management of patients with known or suspected bone metastases participating in NOPR (NaF-PET).”[17] While a goal of CMS in establishing CED for NaF PET was determining whether NaF PET is associated with appropriate changes in the goals of managing osseous metastatic disease and in the associated quality of life or survival,[18] it was also recognized from the inception of the NaF PET registry that NOPR would not be able to obtain definitive evidence of those outcomes given the limitations of a questionnaire-based observational registry without a control group. Indeed, NOPR’s NaF PET and FDG PET registries share the same limitations: the lack of confirmation of actual initiation or cessation of treatments or changes in the use of relevant diagnostic studies, the uncertain effect of patient acceptance and patient preferences on post-scan management intentions, and the lack of a comparator cohort.[19] Notwithstanding these acknowledged limitations, CMS removed the CED requirements for FDG PET on the basis of NOPR data, and we believe that a similar decision is justified for NaF PET on the basis of NOPR data. Second, the Proposed Decision criticizes the design of the NOPR study for “sacrific[ing] external validity, making it difficult to generalize to other populations.”[20] Yet the entire purpose of the CED study—whose class of participants was comprised entirely of Medicare beneficiaries—was to determine solely whether NaF PET was reasonable and necessary for the Medicare beneficiary population. The NOPR Working Group respectfully suggests that whether or not the NOPR CED study is hypothetically generalizable to the non-Medicare beneficiary population is irrelevant for the purposes of this NCD reconsideration. Third, the Proposed Decision raises a concern that the NOPR data may suffer from potential selection bias “because randomization is not possible with this design.”[21] Given the NOPR database case volume, we do not believe that there are material concerns about hypothetical selection bias. For the Medicare population, participation in NOPR was generally the only avenue to obtain NaF PET; hence, the collected data represents most of the patients in the US during the study interval who were considered candidates for such imaging. Moreover, the NOPR Working Group emphasizes that CMS negotiated and approved the NOPR NaF PET CED study design, with full knowledge of its parameters and potential limitations. The NOPR Working Group has always proceeded on the presumption that if structural concerns about selection bias in the study design were significant, CMS would have raised those concerns prior to approving the CED study design. Finally, the Proposed Decision complains that the published evidence fails to show that “use of NaF-18 PET to guide patient management significantly improved health outcomes such as mortality and morbidity” and that “other meaningful health outcomes like avoidance of hospitalizations, avoidance of invasive procedures or other diagnostic tests, other benefits and harms, and quality of life were also not reported.”[22] The Proposed Decision also observes that it is “unclear if the last objectives of the CED studies (improved quality of life or improved survival)” can be met. Such criticisms of the NOPR data are difficult to square with the acknowledgement by CMS that “NOPR may not have been structured to collect health outcomes data,”[23] and the repeated assurances of CMS elsewhere in the Proposed Decision that “[a]s a diagnostic test, NaF-18 PET would not be expected to directly change health outcomes” (emphasis supplied).[24] The CED requirements in Section 220.6.19 of the Medicare Manual are expressly and unequivocally phrased in the alternative, not the aggregate. We thus presume CMS agrees that it was beyond the scope of the CMS-approved NOPR CED study to require that the NOPR data demonstrate “improved health outcomes for beneficiaries.”[25] We encourage CMS to clarify in the Final Decision that an adequate demonstration of change in management alone is a sufficient basis for lifting the CED requirements on NaF PET. C. Coverage Should Extend Beyond One Initial Scan The Proposed Decision suggests that while previous PET decisions related to FDG PET had differentiated between initial and subsequent treatment strategy, CMS “ha[s] not used this distinction for NaF-18 PET for bone metastasis of cancer since it applies more directly to early diagnostic evaluation than to advanced metastatic disease.”[26] The NOPR Working Group is puzzled by this statement, particularly because both initial and subsequent treatment strategy are not only referenced approvingly by CMS in the Proposed Decision itself (“[i]maging to detect bone metastases is also recommended when a patient, following completion of initial treatment, is symptomatic with bone pain suspicious for metastases from a known primary tumor”),[27] but are expressly referenced in the CMS-approved NOPR NaF PET protocol (e.g., B.1.2.2.3 Indication: Initial staging vs. suspected first recurrence vs. suspected development of bone involvement in patients with known metastatic disease). Moreover, as CMS acknowledges in the Proposed Decision, current coverage of NaF PET under CED allows for “prospective data collection used in initial anti-tumor treatment strategy and/or subsequent anti-tumor treatment strategy for NaF-18 PET in identifying bone metastases . . . ”[28] (emphasis supplied). We presume that CMS did not intend to suggest that even if coverage for NaF PET were authorized, that such coverage would be limited to one “initial scan” only. Doing so would be not only inconsistent with standard clinical practice (as other statements in the Proposed Decision recognize), but also with the current Medicare coverage of FDG PET, which CMS allows to be used for diagnostic evaluation of patients as part of subsequent management decision making (e.g., treatment monitoring, restaging after completion of treatment, detection of suspected recurrence), as well as for diagnosis and initial staging. We encourage CMS to clarify its position in this regard in its Final Decision. D. Coverage Should Include Both Oncologic and Limited Non-Oncologic Indications In addition to the data published on NaF PET in identifying bone metastasis of cancer, we strongly believe that the evidence indicates that NaF PET is equal or superior to the current covered technology of conventional BS for non-oncologic bone imaging purposes. Indeed, Section IV of our reconsideration request focuses specifically on these non-oncologic benefits, and expressly requested that CMS “cover NaF PET for bone imaging across a spectrum of non-cancer/benign bone diseases, and favor authorizing local contractor discretion for the use of NaF PET across the broad universe of benign indications.”[29] We were disappointed to note that in the Proposed Decision, CMS declined to address the coverage of non-oncologic uses of NaF PET at all, on the basis that “[s]ince our CED decision was on NaF-18 PET to identify bone metastasis of cancer (CAG-00065R), this reconsideration is limited to NaF-18 PET to identify bone metastasis of cancer.”[30] We continue to believe that NaF can be beneficial for certain limited non-oncologic indications, particularly those that cannot be imaged well with SPECT or SPECT/CT. As noted in our reconsideration request, prospective randomized trials are unlikely to ever be conducted for the specialized non-oncologic clinical indications for which NaF PET is well suited, and the studies in the published literature have the usual limitations and largely consist of single-site, non-comparative series with small sample sizes from across the U.S. and Europe. II. Feasibility of a Confirmatory Study CMS appears to indicate in the Proposed Decision that lifting the CED restrictions on NaF PET would be warranted if an additional study confirmed that the changes in intended patient management found by the NOPR were reflected in evidence of actual changes in patient management.[31] We disagree strongly that confirmatory studies of the NOPR results as to the extent of actual change in management are required under the parameters of the CED study as approved by CMS. We also disagree strongly that the absence of such confirmatory studies precludes CMS from covering NaF PET, in light of the significant quantitative analysis demonstrating significant intended changes in patient management as a result of NaF PET. We also note that as a matter of pure logistics, the proposed twelve-month window is an exceptionally compressed time frame in which to accomplish the proposed task in order to avoid a coverage gap for Medicare beneficiaries. We believe that eighteen months from the Final Decision would be the minimum amount of time necessary for the NOPR Working Group (or other researchers) to obtain the necessary data, draft the requisite analysis, submit for publication, and complete the reconsideration process. We are concerned that a twelve-month time limit could lead to a gap in coverage for Medicare beneficiaries, given the time needed for data analysis, submission for peer- reviewed publication, and the public comment periods required as part of the NCD reconsideration process. In terms of a study design that might meet the demands of the Proposed Decision, one possibility would be a limited-scope retrospective confirmatory study in which CMS claims data from 2012 and 2013 were compared to NOPR data, with the intent of demonstrating that intended management reflects actual management. Once the claims are identified and paired, the study might examine actual claims (inferred actions) at 30-day and 60-day intervals post-scan to evaluate whether the intended management captured in the NOPR data is reflected in the actual management as indicated in the post-scan claims. Accomplishing such a study within the time frame proposed would further be dependent on being able to obtain expedited access to the requisite Medicare claims data for the consented NOPR cohort. III. Conclusion On behalf of the NOPR, we appreciate the assistance and support that CMS has provided to the NOPR over the past decade, and particularly over the past four years with respect to NaF PET. However, we believe that the evidence-based conclusions from our analysis of the extensive NOPR NaF PET data set strongly support ending the CED data collection requirements. To this extent, we strongly disagree with the conclusion of the Proposed Decision that the evidence is insufficient in this regard. We urge CMS to review the evidence in the light of the above comments, and to issue a Final Decision authorizing national coverage of NaF PET for bone metastasis for all oncologic indications. To the extent CMS declines to revisit its Proposed Decision and a confirmatory study is required, we believe that such study should be of limited scope and retrospective. We believe such a study could be based upon linking CMS claims data and NOPR data to determine the relationship between intended management and actual management. Such a study would require the assistance of CMS in expediting the provision of the necessary claims data, as well as a minimum of eighteen months between the date of the Final Decision and the expiration of CED coverage. Finally, we urge CMS strongly to reconsider the limited use of NaF PET for non-oncologic indications at local Medicare Administrative Contractor discretion, based on the position we have articulated above and in our original reconsideration request. We look forward to continuing to work closely with CMS to provide any additional information that would be valuable in supporting our conclusion: that the CED data collection on NaF PET has demonstrated that NaF PET imaging is reasonable and necessary, and thus can be ended without detriment to either the Medicare program or to its beneficiaries. Sincerely, /s/ Bruce E. Hillner, M.D., Chair /s/ Barry A. Siegel, M.D., Co-chair /s/ Anthony F. Shields, M.D., Co-chair * * * [1] National Coverage Analysis (NCA) for Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2), available at https://www.cms.gov/medicare-coverage-database/details/nca-details.aspx?NCAId=279. Because the Proposed Decision does not have page numbers, citations are to the page numbers of the Proposed Decision when printed from the above link as a pdf. [2] As a technical matter, given that CMS has proposed to continue CED coverage pending further research, we presume that CMS intended to state that “the evidence is insufficient to determine that use of a NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer is not reasonable and necessary” (emphases ours). Proposed Decision at 2. To the extent CMS disagrees with our substantive comments and declines to lift the CED restrictions at this time, we would encourage CMS to clarify this phrase throughout its Final Decision. [3] Hillner BE, Siegel BA, Hanna L, et al. Impact of 18F-fluoride PET in patients with known prostate cancer: initial results from the National Oncologic PET Registry. J Nucl Med 2014;55:1-8. [4] Hillner BE, Siegel BA, Hanna L, et al. Impact of 18F-fluoride PET on intended management of patients with cancers other than prostate cancer: results from the National Oncologic PET Registry. J Nucl Med 2014;55:1054-1061. [5] Hillner BE, Siegel BA, Hanna L, et al. 18F-fluoride PET used for treatment monitoring of systemic cancer therapy: results from the National Oncologic PET Registry. J Nucl Med 2015;56:222-228. [6] The Proposed Decision repeatedly and inaccurately references these publications as those of “Hillman et al.” The lead author of the referenced publications is Dr. Bruce Hillner, the chair of the NOPR Working Group. [7] Proposed Decision at 6. [8] Id at 7. [9] Id. [10] Id. at 24. [11] Schirrmeister H, Guhlmann A, Kotzerke J, et al. Early detection and accurate description of extent of metastatic bone disease in breast cancer with fluoride ion and positron emission tomography. J Clin Oncol 1999;17:2381-2389 and Hetzel M, Arslandemir C, König HH, et al. F-18 NaF PET for detection of bone metastases in lung cancer: accuracy, cost-effectiveness, and impact on patient management. J Bone Mineral Res 2003;18: 2206-14. [12] Id. at 24. [13] Segall G, Delbeke D, Stabin MG, et al. SNM practice guideline for sodium 18F-fluoride PET/CT bone scans 1.0. J Nucl Med 2010;51:181301820. [14] Proposed Decision at 24. [15] Id. at 7. [16] See, e.g., Hillner BE, Tosteson TD, Tosteson AN, et al. Intended versus inferred management after PET for cancer restaging: analysis of Medicare claims linked to a coverage with evidence development registry. Med Care. 2013; 51:361–367; Hillner BE, Tosteson TD, Tosteson AN, et al. Intended versus inferred care after PET performed for initial staging in the National Oncologic PET Registry. J Nucl Med. 2013; 54:2024–2031. [17] National Oncologic PET Registry, Operations Manual for NOPR (NaF-PET), at http://www.cancerpetregistry.org/pdf/NOPR%20web%20site%20section%20b_2012.pdf [18] Decision Memo for Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R) (Feb. 26, 2010), available at http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=233. [19] Indeed, the NOPR FDG PET claims linkage study referenced above was published essentially simultaneously with the CMS decision to remove the CED restrictions on FDG PET (CAG-00181R4), and was not referenced in the Final Decision Memorandum. [20] Proposed Decision at 22. [21] Id. [22] Id. at 24. [23] Id. [24] Id. at 7, 21. [25] Id. at 7. [26] Id. at 6. [27] Id. at 3. [28] Id. at 4. [29] Reconsideration Request, at 11. [30] Proposed Decision at 4. [31] Id. at 24. Less On behalf of the National Oncologic PET Registry (NOPR) Working Group, we are pleased to provide these comments on the Proposed Decision Memorandum on Positron Emission Tomography (NaF-18) (CAG-00065R2).[1] The NOPR Working Group appreciates and values its long and continued collaboration with the Centers for Medicare & Medicaid Services (CMS) in utilizing Coverage with Evidence Development (CED) to develop data-driven bases for the reasonable and necessary coverage of various More
Curtis, Melanie	Title: Supervisor Nuclear Medicine & PET/CT Organization: Lake Medical Imaging & Breast Center Date: 10/14/2015 Comment: I, Melanie Curtis, C.N.M.T. from Lake Medical Imaging disagrees with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management. Published in Journal of Nuclear Medicine, Shen et.al1 evaluated the diagnostic accuracy of 18 F NaF PET or PET/CT compared with traditional planar/SPET bone scintigraphy and glucose metabolic PET/CT in the detection of bone metastases. Using twenty published articles, the authors identified and reported data from 1170 patients in their meta-analysis. The pooled sensitivity, specificity and area under the receiver operating characteristic curve of 18F NaF -PET/CT were 92% (95% CI, 89%-95%), 93% (95% CI, 91%-95%) and 0.985 respectively, on a per patient basis. Compared with conventional BS, 18F NaF PET/CT showed both higher sensitivity (96% vs. 88%, P = 0.002) and specificity (91% vs. 80%, P = 0.001). When compared with glucose metabolic PET/CT, 18 F NaF PET/CT showed higher sensitivity (94% vs. 73%, P = 0.003), but no significant difference in specificity (88% vs. 98%, P = 0.06). The authors concluded that 18F NaF -PET has excellent diagnostic capacity for the detection of bone metastases and shows advantages when compared to either conventional bone scans or FDG PET/CT. Less I, Melanie Curtis, C.N.M.T. from Lake Medical Imaging disagrees with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management. Published in Journal of Nuclear Medicine, Shen et.al1 evaluated the diagnostic accuracy of 18 F NaF PET or PET/CT compared with traditional planar/SPET bone scintigraphy and glucose metabolic PET/CT in the detection of bone metastases. Using twenty published articles, the authors More
Phelps, Patrick	Title: President & CEO Organization: SOFIE BIOSCIENCES Date: 10/14/2015 Comment: I understand your desire to see further evidence in publications on the value of NaF over Tc99m. But, I want you to consider another factor. Reactors around the world WILL start to fail, causing further supply interruptions on the starting material of Tc99m. Efforts to find alternative ways to supplement production on cyclotron or newer reactors will NOT occur in time. Not encouraging a move to NaF bone PET scans soon is a mistake. Don't put bone scans at risk.
PATEL, ROMIL	Title: DR. Organization: LAKE MEDICAL IMAGING Date: 10/14/2015 Comment: I disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management. Published in Journal of Nuclear Medicine, Shen et.al1 evaluated the diagnostic accuracy of 18 F NaF PET or PET/CT compared with traditional planar/SPET bone scintigraphy and glucose metabolic PET/CT in the detection of bone metastases. Using twenty published articles, the authors identified and reported data from 1170 patients in their meta-analysis. The pooled sensitivity, specificity and area under the receiver operating characteristic curve of 18F NaF -PET/CT were 92% (95% CI, 89%-95%), 93% (95% CI, 91%-95%) and 0.985 respectively, on a per patient basis. Compared with conventional BS, 18F NaF PET/CT showed both higher sensitivity (96% vs. 88%, P = 0.002) and specificity (91% vs. 80%, P = 0.001). When compared with glucose metabolic PET/CT, 18 F NaF PET/CT showed higher sensitivity (94% vs. 73%, P = 0.003), but no significant difference in specificity (88% vs. 98%, P = 0.06). The authors concluded that 18F NaF -PET has excellent diagnostic capacity for the detection of bone metastases and shows advantages when compared to either conventional bone scans or FDG PET/CT. http://www.ncbi.nlm.nih.gov/pubmed/25290289 Other studies that support the value of 18F NaF in patient management can be found on the SNMMI website in the SNMMI Practice Guideline for Sodium 18F-Fluoride PET/CT Bones Scans. Less I disagree with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management. Published in Journal of Nuclear Medicine, Shen et.al1 evaluated the diagnostic accuracy of 18 F NaF PET or PET/CT compared with traditional planar/SPET bone scintigraphy and glucose metabolic PET/CT in the detection of bone metastases. Using twenty published articles, the authors identified and reported data from 1170 patients in More
Frangioni, John	Title: Professor of Medicine and Professor of Radiology Organization: Harvard Medical School Date: 10/14/2015 Comment: The NOPR CED Study was designed and statistically powered to answer the question requested by CMS, and it appears to have done just that. In fact, the data regarding change in management are overwhelming. Many of us in the field are confused by CMS' position and their request for more data to be collected. Patients will benefit both short- and long-term by the improved sensitivity and resolution of PET compared to SPECT and reimbursing NaF for bone scanning will accelerate this much-needed transition. Less The NOPR CED Study was designed and statistically powered to answer the question requested by CMS, and it appears to have done just that. In fact, the data regarding change in management are overwhelming. Many of us in the field are confused by CMS' position and their request for more data to be collected. Patients will benefit both short- and long-term by the improved sensitivity and resolution of PET compared to SPECT and reimbursing NaF for bone scanning will accelerate this much-needed More
Choyke, Peter	Title: Senior Investigator Organization: National Cancer Institute Date: 10/14/2015 Comment: NaF-18 scans are more sensitive than conventional bone scans. In patients with prostate cancer who are at high risk for metastases (high PSA, high Gleason Grade tumor), but who have a negative conventional bone scan, Na-F-18 scans are particularly useful in identifying metastases thus changing the management in this population. The decision to deny reimbursement for NaF-18 will result in unnecessary treatments and delay in appropriate treatments of the patients.
Hans, Brian	Title: Territiry Manager Organization: PETNET Solutions Date: 10/14/2015 Comment: Hello CMS, I disagrees with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management. Please see below literature as proof of its value. Published in Journal of Nuclear Medicine, Shen et.al1 evaluated the diagnostic accuracy of 18 F NaF PET or PET/CT compared with traditional planar/SPET bone scintigraphy and glucose metabolic PET/CT in the detection of bone metastases. Using twenty published articles, the authors identified and reported data from 1170 patients in their meta-analysis. The pooled sensitivity, specificity and area under the receiver operating characteristic curve of 18F NaF -PET/CT were 92% (95% CI, 89%-95%), 93% (95% CI, 91%-95%) and 0.985 respectively, on a per patient basis. Compared with conventional BS, 18F NaF PET/CT showed both higher sensitivity (96% vs. 88%, P = 0.002) and specificity (91% vs. 80%, P = 0.001). When compared with glucose metabolic PET/CT, 18 F NaF PET/CT showed higher sensitivity (94% vs. 73%, P = 0.003), but no significant difference in specificity (88% vs. 98%, P = 0.06). The authors concluded that 18F NaF -PET has excellent diagnostic capacity for the detection of bone metastases and shows advantages when compared to either conventional bone scans or FDG PET/CT. http://www.ncbi.nlm.nih.gov/pubmed/25290289 Other studies that support the value of 18F NaF in patient management can be found on the SNMMI website in the SNMMI Practice Guideline for Sodium 18F-Fluoride PET/CT Bones Scans. 1. Shen CT, Qiu ZL, Han TT, Luo QY. Performance of 18f-fluoride PET or PET/CT for the detection of bone metastases: a meta-analysis. Clin Nucl Med. 2015;40:103-10. In my opinion, NaF Bone PET should be covered in its entirety (Meaning for both Oncology and Non-Oncologic applications.) We can do better so we should. Brian Hans BA, RT(N), CNMT Less Hello CMS, I disagrees with the proposed decision and feel strongly that 18F NaF should be nationally covered by CMS because of its value in patient management. Please see below literature as proof of its value. Published in Journal of Nuclear Medicine, Shen et.al1 evaluated the diagnostic accuracy of 18 F NaF PET or PET/CT compared with traditional planar/SPET bone scintigraphy and glucose metabolic PET/CT in the detection of bone metastases. Using twenty More
Frank, Richard	Title: MD, PhD, Chief Medical Officer Organization: Siemens Healthcare Date: 10/13/2015 Comment: October 12, 2015 CAGInquiries@cms.hhs.gov Tamara Syrek Jensen, Esq. Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Re:Comments on Proposed Decision Memorandum (CAG-00065R2)Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer Dear Director Syrek Jensen; On behalf of Siemens Healthcare, thank you for opening the consideration to end prospective data collection requirements under Coverage with Evidence Development (CED) for use of NaF-18 PET submitted by the National Oncologic PET Registry (NOPR). Siemens Healthcare develops innovations that support better patient outcomes with greater efficiencies, giving clinicians the confidence they need to meet the clinical, operational and financial challenges of a changing healthcare landscape. By bringing together innovative positron emission tomography (PET) imaging with computed tomography (CT) or magnetic resonance (MR) technologies and PET radiopharmaceuticals that set new standards in patient care, we at Siemens help our customers deliver quality patient care. Siemens Healthcare is disappointed that the Centers for Medicare and Medicaid Services (CMS) did not find the data reported by the National Oncology PET Registry (NOPR) to be sufficient to support the conclusion that NaF-18 PET is reasonable and necessary to determine the choice of therapy in the range of metastatic cancers, but particularly prostate and breast cancers. Published data suggesting that use of NaF-18 PET results in a change in planned therapy in 40% of patients, reduction in downstream diagnostic testing in 70% of patients, and avoidance of invasive procedures in 50% of patients persuades to the conclusion that NaF-18 PET is not only reasonable but truly necessary for clinical efficiency in staging cancer.^1-3 These efficacies and efficiencies are the unsurprising result of the superior diagnostic accuracy, sensitivity, and specificity demonstrated for NaF-18 PET over other diagnostic procedures such as CT alone. For these reasons, Siemens Healthcare strongly recommends that CMS reconsider the draft determination and find in favor of coverage. More specifically, we recommend CMS remove the requirement for prospective data collection for coverage of NaF PET for oncologic indications and delegate to the local Medicare Administrative Contractors (MACs) the determination of coverage for non-oncologic indications, similarly as was determined by CMS from its recent reconsideration of the CED for fluorodeoxyglucose positron emission tomography (FDG PET) for oncologic indications. It is the belief of Siemens Healthcare that the proposed requirement for accumulation of an additional 12 months of patient data would be an unnecessary delay in making a favorable coverage decision. More serious, however, would be any requirement for additional parameters in the assessment beyond those originally agreed with CMS. Analysis of parameters not originally envisioned may render the analysis infeasible by virtue of the necessity of re-consenting patients for collection of the additional data. Furthermore, Siemens Healthcare believes it would be an inappropriately high standard to require classical therapeutic outcome data, or evidence of costs which rely on such outcomes, to support coverage for a diagnostic procedure. The role for a diagnostic procedure is to inform choice of therapy, which is an appropriate standard for clinical evidence for coverage determinations. The imposition of additional parameters would contribute to variability, thereby unfairly biasing the statistical analysis against the diagnostic. The standard which should be used is based on precedent from the coverage determination for FDG PET/CT, ie change in intended clinical management. If, however, the determination is to delay coverage pending additional evidence, it is important that CMS commit to uninterrupted coverage under CED until such time as CMS completes any subsequent National Coverage Assessment culminating in a National Coverage Determination fully implemented via transmittals guiding the submission of claims. Patients served by CMS deserve uninterrupted access to NaF-18 PET to support the selection of the best choice of therapy, and a de facto hiatus in coverage, pending transmittals, would be inappropriate. The benefits of NaF PET could accrue also to healthcare delivery systems under new payment schemes by reduction in other diagnostic and invasive procedures, if not also the natural conclusion that better treatment now might well reduce the likelihood of, or at least delay the occurrence of, re-hospitalization. In conclusion, Siemens Healthcare thanks CMS for opening the consideration to end prospective data collection requirements under Coverage with Evidence Development (CED) for use of NaF-18 PET submitted by the National Oncologic PET Registry (NOPR) in a highly cooperative manner. Siemens is committed to discovering, developing and delivering molecular imaging solutions that enable physicians to improve outcomes for their patients. National coverage for NaF-18 PET for use in the initial staging and subsequent treatment strategy of cancer would be an important milestone in ensuring patients receive the most valuable clinical information, aiding the selection of the most appropriate therapy, thereby improving quality of life of, overall survival for, and clinical efficiency in the delivery of care to, cancer patients in the United States. Therefore, we recommend CMS remove the requirement for prospective data collection for coverage of NaF PET for oncologic indications and delegate to the local Medicare Administrative Contractors (MACs) the determination of coverage for non-oncologic indications, similarly as was determined by CMS from its recent reconsideration of the CED for FDG PET for oncologic indications. Sincerely, Richard Frank, MD, PhD Chief Medical Officer Siemens Medical Solutions, USA Inc. 1 Segall, George M. PET/CT with Sodium 18F-Fluoride for management of patients with prostate cancer 2 Hillner BE, Siegel BA, Hanna L, et al. Impact of 18F-fluoride PET in patients with known prostate cancer: initial results from the National Oncologic PET Registry. J Nucl Med 2014;55:1-8. 3 Hillner BE, Siegel BA, Hanna L, et al. Impact of 18F-fluoride PET on intended management of patients with cancers other than prostate cancer: results from the National Oncologic PET Registry. J Nucl Med 2014;55:1054-1061. Less October 12, 2015 CAGInquiries@cms.hhs.gov Tamara Syrek Jensen, Esq. Director, Coverage and Analysis Group Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Re:Comments on Proposed Decision Memorandum (CAG-00065R2)Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer Dear Director Syrek Jensen; On behalf of More
Goodwin, Mary	Title: Mrs. Date: 10/12/2015 Comment: I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Regards, Mary Goodwin Less I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy More
Bridges, Robert	Title: M.D. Organization: Aegis Imaging Consultants Date: 10/12/2015 Comment: I wish to comment on the present status of determination by CMS on the decision against expanded utilization and reimbursement of NaF-18 for diagnosis of malignant bone disease. As a diagnostic imaging specialist, being boarded in both diagnostic radiology and nuclear medicine with over 30 years of clinical experience, and as both an early adopter of NaF-18 bone imaging and the pioneer of PET imaging in Alaska, I have taken a keen interest in the comments, evaluation and determination of use of NaF-18 by CMS. Historically, the introduction of F-18 FDG PET and PET/CT imaging has provided an extremely valuable modality for the detection, staging and assessment of therapy for numerous cancers. The process of expanded approval for use of F-18 FDG through NOPR proved that this biomarker does provide true diagnostic value and improved patient outcomes. However, from experience gained both personally and through review of the published literature, F-18 FDG does have significant shortcomings in detecting all bony involvement by malignant disease and is not the all-encompassing biomaker that many had hoped for and some continue to champion. I have utilized NaF-18 for both for oncology work and for general osteoscintigraphy. Matching the experience of years of use of Technetium labeled phosphonate scans with years of experience gleaned from utilizing NaF-18 should be considered more than “anecdotal”. I have found it universally superior to the TC99m labled phosphonate agents for all bone scanning indications. Additionally, the literature does provide examples of dedicated head-to-head comparisons of standard bone imaging with NaF-18 PET imaging as noted with the studies of Schirrmeister¹, Evan-Sapir², Yen³, and Chang⁴ along with the meta-analysis of Shen et al⁵. In these peer reviewed studies, NaF-18 is superior in sensitivity and specificity when compared to phosphonate scans including SPECT/CT and Shen also found that in many instances NaF-18 was more diagnostic than F-18 FDG5. The extensive data derived from the NaF-18 NOPR trials revealed a 40 percent change in intended treatment. This echoes the changes in treatment from the early F-18 FDG trials that lead to its CMS approval. The powerful and dynamic osteoblastic response of the body to injury and the resultant deposition of NaF-18 may be more diagnostic than the complex requirements of F-18 FDG to be visualized which need intact cell wall transport and critical thresholds for tumor mass, cellular density, and metabolic activity. When compared to the phosphonate compounds, NaF-18 may have upwards of eight times (8x) greater deposition in malignant bony lesions. Cancers such as lung and breast, while presenting with a majority of bony metastases that are F-18 FDG avid, may in many cases have metastatic bony involvement first detected by NaF-18 where the aggregate of necessary thresholds for D-18 FDG is below detection. I have shown such a F-18 FDG negative but NaF-18 positive lesion in my published article in JNMT6 for a patient with poorly differentiated adenocarcinoma of the lung metastatic to bone. In the early experience with F-18 FDG, it proved its value by changing the course of treatment in part by precluding costly, inappropriate if not futile treatment for metastatic disease than had been under-staged as possibly curable by conventional imaging. This has helped re-define appropriate care and appropriate patient expectations. NaF-18, as an adjunct to F-18 FDG, can further focus and refine the precision in early diagnosis of malignant disease and, with it, better direct appropriate care of the patient. I urge re-evaluation of the coverage determination and that NaF Bone PET can gain full approval for use in oncologic evaluation of bony metastasis. Respectfully, Robert L. Bridges, MD References: 1. Schirrmeister, J Nucl Med 2001; 1800-04 2. Even-Sapir. J Nucl Med 2006;47:287-97 3. Yen et al. Nucl Med Commun 2010;31:637-645 4. Chang CY et al. Acta Radiol. 2014 Dec 22 5. Shen et al Clin Nucl Med. 2015 Feb;40(2):103-10 6. Bridges RL et al J. Nucl. Med. Technol. June 2007 35:64 Less I wish to comment on the present status of determination by CMS on the decision against expanded utilization and reimbursement of NaF-18 for diagnosis of malignant bone disease. As a diagnostic imaging specialist, being boarded in both diagnostic radiology and nuclear medicine with over 30 years of clinical experience, and as both an early adopter of NaF-18 bone imaging and the pioneer of PET imaging in Alaska, I have taken a keen interest in the comments, evaluation and determination of More
Amos, Donna	Date: 10/03/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Garner, Lynda	Date: 10/03/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Hardin, Cam	Date: 10/03/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Mendola, Michael	Date: 10/03/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Moore, Gary	Title: Mr Date: 10/02/2015 Comment: To whom this may concern, I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Regards, Gary Moore 1426 Orange St Berwick, PA 18603 Less To whom this may concern, I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Alyabari, Sandra	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Berg, Deborah	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Blackwood, Barbara	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Braeback, Cathryn	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Brown, Cynthia	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Carpenter, Dorothy	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Cieslinski, James	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Clark, Kathy	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Cooper, LeRoy	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Diamond, Patti	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Frank, Carole	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Fromwiller, Judith	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Granger, Deborah	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Horsch, Thomas	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Lipinski, Lisa	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Lloyd, William	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
MacKay-O'Brien, Caryn	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
mazur, *	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Micham, Terence	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Nussbaum, Wilfred	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
O'Brien, Robert	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Pullen, Pamela	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Richards, Sallie	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Salerno, Barbara	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
sulla, Gaitano	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
sulla, Felice	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
sulla, carol	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Verdon, Lucia	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Wauben, Phillip	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Webber, Joan	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Yoder, Lynnette	Date: 10/02/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
*, huey	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
angrisani, cynthia	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Apsche, Joanne	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
B, dennis	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Bloyd, Genell	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Boggio, Frank	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Borelli, Candace	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Brown, Elizabeth	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Brzezinski, Debra	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Cicci, Diane	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
colon, Maria	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Deal, Floyd	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
DeVries, Sidney	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
downes, dorien	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Edwards, Ruth	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
fazio, sandra	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Fisher, Kenneth	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Haigh, Constance	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Hart, Michele	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Hill, Karen	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
J, Dane	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Kemp, Suzanne	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Kuntz, Stephen	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Lamer-Thomas, Laura	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
landers, Mary	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
madsen, Jeri	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
McCorriston, Catherine	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Morrow, Linda	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
murray, anita	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Nix, Jean	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Organ, Ann	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Philpot, Adrienne	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Renner, Vickie	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Richter, William	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Robison, Janet	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Rodriguez, Patricia	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Shafkind, Gale	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Steiner, David	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Steiner, Sharon	Date: 10/01/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Dembny, Kathleen	Organization: . Date: 09/30/2015 Comment: PET(NaF-18) was a key part of treatment fir [PHI Redacted] and for a dear friend. Denying this is playing Russian Roulette with the lives of those who HAVE PROVIDED THE MONEY the federal government now seeks to withhold!!
Lowentritt, Benjamin	Title: Physician Organization: Chesapeake Urology Associates Date: 09/30/2015 Comment: It is very disappointing that after several years of compiling information, CMS has decided not to cover Sodium Fluoride PET scanning. I treat men with advanced, metastatic prostate cancer, and the improved specificity and earlier diagnosis of bone metastases provided by NaF PET has allowed dozens of my patients access to treatment otherwise not allowable. The finding of metastatic disease is necessary for access to most treatments for these patients, and all these treatments are shown to work better the earlier they are started. Going back to traditional Bone Scans will delay the recognition of metastatic disease and will lead to poorer outcomes for patients. Traditional PET scanning does not help in the diagnosis of metastatic prostate cancer, and my experience with NaF PET scan results has been extremely positive. On behalf of my patients, please reconsider. Less It is very disappointing that after several years of compiling information, CMS has decided not to cover Sodium Fluoride PET scanning. I treat men with advanced, metastatic prostate cancer, and the improved specificity and earlier diagnosis of bone metastases provided by NaF PET has allowed dozens of my patients access to treatment otherwise not allowable. The finding of metastatic disease is necessary for access to most treatments for these patients, and all these treatments are shown to More
abner, Patricia	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Ali, Doreen	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Baker, Virginia	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Brauneck, Ruth	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
bridges, Caroline	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Christensen, Vickie	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Corsi, Lawrence	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Duval, Robin	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Grimaud, Diane	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Haire, Carolyn	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
L, Christine	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Lindeman, Jan	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Lix, Robert	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown More
MacKenzie, Gilbert	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
maryanski, patricia	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Moore, Gayle	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
morden, Mark	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Moretz, Sean	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Olsen, Alfred	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Resende, Stephen	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Riffe, Regina	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Robbins, Linda	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Smogoleski, Suzanna	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Tyndall, James D.	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Woodcox, Jean	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Wren, Jennifer	Date: 09/30/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Dicks, Brian	Title: Urologist Date: 09/29/2015 Comment: I encourage CMS to reconsider their position regarding coverage for NaF Pet scans. As a practicing urologist I have been very impressed with the ability to detect early bone metastasis in my prostate cancer patients who have had a negative bone scan. There have been many developments in the realm of castrate resistant prostate cancer and early detection of bone metastasis allows us to aggressively treat these mets with a number of novel agents. This clearly leads to better palliation of local symptoms and disease control. NaF Pet CT combines anatomic detail and metabolic information in one study and rarely requires additional radiographic studies as is the norm with a conventional bone scan. Thank you for your consideration. Less I encourage CMS to reconsider their position regarding coverage for NaF Pet scans. As a practicing urologist I have been very impressed with the ability to detect early bone metastasis in my prostate cancer patients who have had a negative bone scan. There have been many developments in the realm of castrate resistant prostate cancer and early detection of bone metastasis allows us to aggressively treat these mets with a number of novel agents. This clearly leads to better palliation of More
Henry, Wendy	Date: 09/29/2015 Comment: To whom this may concern, My [PHI Redacted] passed away from prostate cancer in [PHI Redacted], less than one month past his 67th birthday. He fought a gallant, pain-filled battle from his diagnosis just two years before until his cancer-wrenched body no longer could fight. In the end, there was nothing more the doctors could do. His oncologist cried when he told [PHI Redacted] the treatments were finished. I will never forget the drugged and withered body, lying in a nursing hospital bed, that used to be a vital and active cyclist and sailor. [PHI Redacted] [PHI Redacted] was diagnosed at his Welcome to Medicare physical; he had stage-3 prostate cancer, and it had already metastasized to his pelvic bones. Because he did not have medical insurance before Medicare, he put off the vital check-ups that would have caught the cancer in it's early stages. Even so, the doctors were able to identify the bone cancer through the NaF-18 positron emission tomography (PET) scan and begin aggressive treatment. The treatments were able to eradicate the bone cancer, and give him many more months to live. He was able to spend much time with his family, get his affairs in order, and turn over his print jobbing business to someone else, leaving his many customers in good hands for their advertising and office supply needs. This was also a time of spirtual renewal and reconciliation for him; he touched many lives in those final two years, settling his affairs, and providing for his minor child's emotional and financial future. Now, my husband and I rely on Medicare and Tricare-for-life, for our own healthcare. My husband counts on the best testing available, to make sure he can remain cancer-free and/or treatable. [PHI Redacted] He deserves the best tests and treatments, and I am here to advocate so he get them. Therefore, I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Regards, Wendy Henry Less To whom this may concern, My [PHI Redacted] passed away from prostate cancer in [PHI Redacted], less than one month past his 67th birthday. He fought a gallant, pain-filled battle from his diagnosis just two years before until his cancer-wrenched body no longer could fight. In the end, there was nothing more the doctors could do. His oncologist cried when he told [PHI Redacted] the treatments were finished. I will never More
Belias, Elena	Date: 09/29/2015 Comment: To whom this may concern, I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Regards, Elena Belias 93-49 214th Pl Queens Village, NY 11428 Less To whom this may concern, I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
SMITH, MARY	Organization: BORG & IDE IMAGING Date: 09/29/2015 Comment: To whom this may concern, I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Regards, Mary Smith 722 Dewey Ave, Uppr Rochester, NY 14613 Less To whom this may concern, I’m writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Andre, Jill	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Austill, Norman	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Baker, Deborah	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Bilyeu, Sheryl	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Bohler, Judith	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Burnette, Linda	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
dondelinger, virginia	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Douglas, David	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Estades, Jorge	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Globke, Ellen	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Greenfield, Jody	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
H, Jolene	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
HaringDavner, Lisa	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Hildreth, Jean	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
hill, Colleen	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Holley, Doug	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Huddlestom, Leslie	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Hudson, James	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Larson, Muriel	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Marshall, Terri	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
mastriano, Denise	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
mcphail, Jack	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
MEROLA, DEBORAH	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Mules, Carole	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Ozor, Barbara	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
R, Steve	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Racette, Annette	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Roberts, Rosemary	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Ross, Dakita	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Ruggiero, Barbara	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Senanefes, Barbara	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Shillinglaw, Donald	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Smith, Phillip	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Spears, Vickie	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Stephenson, Linda	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Stockton, Marilyn	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Stoudt, Donald	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Stroup, Shari	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
T, Sue	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Timothy, Patricia	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Tresvik, Germaine	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Tyner, Julia	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
uhl, debra	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
wood, James	Date: 09/29/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Bourgault, John	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Butow, Vicky	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Cannella, Rita	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
dalton, colleen	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Dingman, Vicki	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Dunne, Lucille	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Greve, David	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Gueck, M.	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Hickson, Nedra M.	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
LAYTON, DALE	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Little, Pam	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
miller, terry	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
morris, cheryl	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Norris, Barbara	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Rosas, Ruth	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Seymour, Karen	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Snyder, Mary	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Ueberroth, Nancy	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Vix, Janice	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Ward, Teresa	Date: 09/28/2015 Comment: To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to provide the highest diagnostic accuracy in identifying patients that need treatment for bone metastasis. The scan gives patients an accurate picture of their health and enables doctors to diagnose and treat patients to the best of their ability. NaF PET has benefited tens of thousands of prostate cancer patients. Without coverage, many patients will lose access and their health may be in jeopardy. On behalf of patients across the country, please reconsider the decision to cut coverage for this critical scan. Less To whom this may concern, I'm writing to urge the Centers for Medicare and Medicaid Services to reconsider its recent decision regarding coverage for the NaF-18 positron emission tomography (PET) scan to identify bone metastasis of cancer and instead finalize a decision to cover this important scan. I know first-hand the critical role of advanced diagnostic tools in helping prostate cancer patients achieve a better quality of life. The NaF PET scan has been shown to More
Middlebrooks, James Tyler	Title: Nuclear Medicine Technologist Organization: CARTI Diagnostic Imaging Date: 09/25/2015 Comment: I personally have seen numerous times where a patient's PSA was at a 1.5 and above and bone Mets were detected with a negative conventional bone scan. This allows patients to start chemo earlier and detect cancer before it spreads/grows large enough for a conventional bone scan to detect. Please reconsider the coverage of this exam. It is an extremely helpful tool in improving patent health and overall survival rates. Please reconsider and allow coverage through CMS. your truly, James Tyler Middlebrooks Less I personally have seen numerous times where a patient's PSA was at a 1.5 and above and bone Mets were detected with a negative conventional bone scan. This allows patients to start chemo earlier and detect cancer before it spreads/grows large enough for a conventional bone scan to detect. Please reconsider the coverage of this exam. It is an extremely helpful tool in improving patent health and overall survival rates. Please reconsider and allow coverage through CMS. your truly, More
Cullari, Thomas	Date: 09/17/2015 Comment: I have found many patients to benifit from the technology offered in F-18 Bone scan in comparison to a planer bone scan. Many physicians have been unsucseful in finding bone mets with the old technology and thus had to order the exam several times to only find that the mets have spread exstensively. The early detection that is provided by NaF is monumental. The sensitivity and spcificity numbers alone would convince anyone who needed this type of exam to choose NaF over planer any day. We are trying to save lives here arent we? Less I have found many patients to benifit from the technology offered in F-18 Bone scan in comparison to a planer bone scan. Many physicians have been unsucseful in finding bone mets with the old technology and thus had to order the exam several times to only find that the mets have spread exstensively. The early detection that is provided by NaF is monumental. The sensitivity and spcificity numbers alone would convince anyone who needed this type of exam to choose NaF over planer any day. We are More
Pepe, Michele	Title: Manager Radiology Organization: Yale New Haven Hospital Date: 09/17/2015 Comment: I do not fully agree with the decision CMS has made about NaF18 bone imaging. We all decide to go into the medical field for patient care and providing a service to all patient to diagnose, treat and care. We are doing an injust to men with prostate cancer by not providing NaF18 bone imaging, I have seen negative Tc99m bone scans and same patient repeated with NaF18 be postive, again we are all in this for patient care.
Messer, Guy	Title: CEO Organization: Trident Medical Imaging Date: 09/16/2015 Comment: While I appreciate the thoroughness of CMS' evaluation, I am concerned that CMS is instituting undue restrictions in the approval process. CMS itself initiated the national clinical trial process to evaluate new PET tracers and indications such as F-18 PET Bone Scans and when the data provided overwhelmingly supports its use, CMS adds another layer of restricted utilization in the form of a 12-month extension to answer the question that appears to have already been answered by the trial data. The NOPR data is compelling as are the studies cited in CMS' own decision. I strongly urge CMS to reconsider their decision and approve F-18 PET Bone Scans for the evaluation of bone metastasis. Less While I appreciate the thoroughness of CMS' evaluation, I am concerned that CMS is instituting undue restrictions in the approval process. CMS itself initiated the national clinical trial process to evaluate new PET tracers and indications such as F-18 PET Bone Scans and when the data provided overwhelmingly supports its use, CMS adds another layer of restricted utilization in the form of a 12-month extension to answer the question that appears to have already been answered by the trial More

Submit Feedback/Ask a Question

Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer

Public Comments

Page Help for NCA - Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2) - View Public Comments

View Public Comments

Printing a Document to PDF

Get email updates

CMS & HHS WEBSITES

HELPFUL LINKS

RSS FEEDS