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Rush Introduces Bipartisan Legislation to Expand Access to Lifesaving Diagnostics, Ensure Low-Income Patients Aren't Left Without

July 16, 2021

Under current payment system, safety-net hospitals serving vulnerable populations often cannot afford to offer the best, most accurate diagnostics

WASHINGTON — Today, U.S. Representatives Bobby L. Rush (D-Ill.), Scott Peters (D-Calif.), Neal Dunn (R-Fla.), and Greg Murphy (R-N.C.) introduced the bipartisan Facilitating Innovative Nuclear Diagnostics (FIND) Act of 2021, which would ensure that low-income patients do not lose access to targeted radiopharmaceutical diagnostics. These diagnostics — small amounts of radioactive material used to capture molecular-level images of what is happening in a patient's body — can quickly and accurately diagnose diseases, including Alzheimer's, Parkinson's, and certain cancers, to ensure patients get the right treatments early on.

Unfortunately, under the current payment methodology, many hospitals — in particular, safety-net hospitals serving high numbers of Medicare patients — are unable to cover the cost of radiopharmaceuticals, which means that vulnerable patients are left without access to the best diagnostics and care. The FIND Act would ensure adequate Medicare reimbursement to hospitals for procedures that use radiopharmaceuticals to diagnose, evaluate, and treat specific conditions including certain cancers. The bill is budget neutral, as the reimbursement change does not cost any taxpayer money.

"We cannot tolerate a two-tiered health care system — one for the rich, and one for everyone else," said Rep. Rush. Unfortunately, many low-income and minority patients are being denied access to the most efficient tests, therapies, and care due to the current payment structure for diagnostic radiopharmaceuticals that makes it nearly impossible for many hospitals serving our most vulnerable populations to offer these life-saving diagnostics. The FIND Act is important legislation to help fix this disparity."

"Alzheimer's disease, prostate cancer, and other life-altering conditions have a disproportionate impact on Black Americans and other minority communities. Ensuring that the best diagnostic tools are available to identify these diseases in patients earlier, when they are the most treatable, is essential."

In April 2021, Rep. Rush sent a letter to Centers for Medicare & Medicaid Services (CMS) Acting Administrator Elizabeth Richter urging CMS to classify diagnostic radiopharmaceuticals as drugs and remove them from the current reimbursement packaging. In May, Rep. Rush met with CMS for an update and raised concerns that the current approach creates a two-tiered system for patients. Following this meeting, on May 10, 2021, Rush sent a letter to U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra raising similar concerns about the payment structure for diagnostic radiopharmaceuticals and requesting a meeting. That letter has not yet received a response.

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Issues:Health Care