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House Committee on Energy and CommerceHealthHouse Committee on Ways and MeansIntroducedOctober 22nd, 2009
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Medicare Nuclear Medicine Payment Group Clarification Act of 2009
To amend title XVIII of the Social Security Act to modernize and improve the Medicare payment methodology for radiopharmaceuticals under the hospital outpatient prospective payment system and to ensure equitable payment and patient access to certain low volume, high cost radiopharmaceuticals.
Medicare Nuclear Medicine Payment Group Clarification Act of 2009 - Amends title XVIII (Medicare) of the Social Security Act to revise requirements for treatment of certain costs for a nuclear medicine group in the prospective payment system (PPS) for hospital outpatient department services. Declares that services classified within a nuclear medicine group shall not be treated as comparable with respect to the use of resources, and therefore shall be excluded from the group, if the highest median cost (or, at the Secretary's election, mean cost) of any associated diagnostic radiopharmaceutical included in the payment for the service within the group is more than two times greater than the lowest median cost (or mean cost, if so elected) for a service within the group.