OUR MINDS. OUR LIVES. OUR CHOICES.
Voices of Alzheimer's Letter to CMS Regarding Payment Bundling for Alzheimer’s Treatments
May 2, 2024
Ms. Chiquita Brooks-LaSure, Administrator
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244-1850
Dear Administrator Brooks-LaSure:
On behalf of the undersigned supporting organizations, and the millions of Americans living
with Alzheimer’s disease, we urge the Centers for Medicare and Medicaid Services (CMS)
to expeditiously take action to address the known issues related to payment bundling for
PET scan tracers, unpackaging diagnostic radiopharmaceuticals and paying for them
separately from other procedure costs. The current policies inadequately support access
to these tests, which is preventing people living with and at risk of Alzheimer’s from
receiving the appropriate scans and subsequent diagnoses.
For years, we lacked the ability to diagnose and treat Alzheimer’s effectively and many went
without that confirmation. But now, the tools exist to help support and improve the lives of
people with Alzheimer’s, and CMS must do everything possible to ensure timely access to
these solutions. Lack of progress related to payment bundling for innovation that assist
diagnosis is a delay that has significant negative impacts our community.
Early diagnosis allows affected individuals a wider range of effective treatment options and
more time to develop comprehensive, personalized care and treatment plans. Yet, despite
the proven benefits of early detection and diagnosis, the rate of undetected dementias in
the U.S. is estimated at 61 percent, and only 11 percent of people with incident mild
cognitive impairment (MCI) report receiving a timely diagnosis. Access to beta-amyloid PET
scans is crucial to ensuring timely and accurate diagnosis. Estimates indicate that about
half of the capacity for beta-amyloid PET scans in the United States today is inaccessible
because of current barriers, including a payment bundling structure that disincentivizes
these tests.
This problem has existed since my wife Geri was diagnosed with Alzheimer’s disease in
2012; she is now in the late stage of the disease, and I very much wish to tell her that this
issue has been resolved. Every day, more than 2,000 people transition to a more advanced
stage of Alzheimer’s, where they are no longer eligible for existing treatments. Better
access to beta-amyloid PET scans allows people to receive an accurate diagnosis of
Alzheimer’s more quickly and, when eligible, begin one of the available disease-modifying
therapies that can slow the onset of the disease, extend independence, and improve
quality of life.
Now is the time to solve the remaining issues that are delaying and preventing access for
so many.
Thank you for your consideration.
Sincerely,
Jim Taylor
President & CEO
Voices of Alzheimer’s
Joined by:
Alliance for Aging Research
Partnership to Fight Chronic Disease
UsAgainstAlzheimer’s