PET and the Comprehensive Facility Requirement

The Australasian Association of Nuclear Medicine Specialists (AANMS)  has been made aware of several enquiries to the Department of Health regarding PET services.  The AANMS would take the opportunity to note that:

Clause 2.4.2 in the Diagnostic Imaging Services Table Regulations (DIST) requires Medicare funded PET services to be performed in a ‘comprehensive facility’. Comprehensive facility is defined in Part 3 of the DIST as ‘a facility where all of the following services are performed (whether or not other services are also performed) : PET, computed tomography, diagnostic ultrasound, medical oncology, radiation oncology, surgical oncology and x-ray’.

Further, clause 2.4.5 in the DIST requires the owner or operator of PET equipment to make a written declaration to the Chief Executive of Medicare that the place where Medicare funded PET services are provided, is a ‘comprehensive facility’. In making such a declaration, the owner or operator is asserting that all elements of the requirement have been met.

The intention of the ‘comprehensive facility’ requirement is to ensure that the services required for cancer diagnosis and treatment are provided in a location that allows patients to have access to high quality, multi-disciplinary care. Ready access to imaging, and the specialists reporting these images, facilitates the multidisciplinary team (MDT) process and allows for consistency of reporting and regular feedback.  Best practice for PET provision and interpretation is best achieved when the scans are able to be assessed in light of other relevant factors of patient history and treatment options.

To achieve this, PET services are hospital or cancer-centre based where there is a formal network of patient care. When the ‘comprehensive facility’ definition was reviewed in 2018 by the Diagnostic Imaging Clinical Committee (DICC) of the Medicare Benefits Schedule (MBS) Review Taskforce, the DICC agreed the definition should be retained to prevent the proliferation of low-quality PET services without the context of appropriate cancer service provision. The DICC also agreed that PET should be performed in a hospital setting with the involvement of the patient’s referring doctor where appropriate.

All Medicare funded diagnostic imaging services, including PET services must be rendered from a practice accredited under the Diagnostic Imaging Accreditation Scheme (DIAS).

Ultimately, it is the responsibility of individual business owners to undertake their own due diligence. If it is your intention to establish a practice providing Medicare funded PET services, you will need to ensure that the operational arrangements meet the legislative requirements.

The AANMS supports these measures which are designed to ensure best practice in PET service provision. We would also take the opportunity to strongly reinforce our support for personal supervision in nuclear medicine and PET and our belief that personal supervision provides a better imaging outcome and improved patient care.

29 June 2020

AANMS Elects New President Dr Geoff Schembri

On 8 May 2020 the AANMS held their Annual General Meeting. The meeting elected the new Board for the next two years – 2020-2022.

The New AANMS President is Dr Geoff Schembri FRACP FAANMS (NSW). Geoff was previously Vice President of the AANMS.

The AANMS Board for 2020-2022 are:

President
Dr Geoffrey (Geoff) Schembri FRACP FAANMS (NSW)

Vice-President 
Associate Professor Sze Ting Lee FRACP FAANMS (VIC)

Honorary Treasurer 
Dr Michelle Nottage FRANZCR FAANMS (SA)

Immediate Past President 
Associate Professor Paul Thomas FRACP FAANMS (QLD) (ex officio)

DIRECTORS
Associate Professor Nathan Better FRACP FCSANZ FAANMS (VIC)
Dr Scott Beuzeville FRACP FAANMS (NSW)
Dr Samuel (Sam) McArthur FRANZCR FAANMS (VIC)
Dr Lisa Tarlinton FRANZCR FAANMS (NSW)
Dr Elizabeth Thomas FRACP FAANMS (WA)
Dr Eva Wegner FRACP FAANMS (NSW)

Therapeutic Goods Amendment (Radiopharmaceutical and Radiopharmaceutical Active Ingredients) Regulations 2020

In April the AANMS wrote to the Federal Minster for Health Greg Hunt requesting, under his powers in the Therapeutic Goods Act Section 18A Exemption because of emergency, to remove the current restrictions to supply within the same State or Territory, and also the restriction to only supply hospitals or public institutions.

On 2 May the Therapeutic Goods Amendment (Radiopharmaceutical and Radiopharmaceutical Active Ingredients) Regulations 2020 came into effect. The purpose of the Regulations is to enable public and private hospitals and public institutions that do not hold a manufacturing licence under the Act to manufacture radiopharmaceuticals or radiopharmaceutical active ingredients (RAI) for the treatment of a patient in another State or Territory, so that the radiopharmaceuticals or RAI can be transported to the patient in a timely manner. This eliminates the need for patients to travel interstate for diagnosis or treatment.

As AANMS advocated for, the exemption is necessary to facilitate the continued supply of radiopharmaceuticals to patients around Australia which has been negatively impacted by the unforeseen reduction in commercial flights between Australian capital cities caused by the COVID-19 emergency.

Where a hospital or institution is able to obtain sufficient supplies of radiopharmaceuticals or RAI from a manufacturer licensed under the Act, the radiopharmaceuticals or RAI should be obtained from that licensed manufacturer. The exemptions will apply for the duration of the COVID-19 outbreak.

To see the full Explanatory Statement https://www.legislation.gov.au/Details/F2020L00544/Explanatory%20Statement/Text 

To see the full Therapeutic Goods Amendment 2020 https://www.legislation.gov.au/Details/F2020L00544

MBS Diagnostic Imaging and Related Changes Effective 1 May 2020 – Item 61505 and PET

As the reimbursement rate for the PET item numbers was set prior to the PET/CT era, the AANMS has successfully made the case with the Department of Health that item 61505 should be extended to PET because of the additional time and cost of providing this service. Item 61505 will be co-claimable with PET items from 1 May 2020.

Item 61505 (CT scan performed at the same time and covering the same body area as single photon emission tomography for the purpose of anatomic localisation or attenuation correction where no separate diagnostic CT report is issued and only in association with items 61302 – 61650) has until now been limited to SPECT only.

Note that the existing DOTA PET item number currently includes the 61505 equivalent $100 fee and this items’ fee will be reduced by $100 to allow 61505 to be claimed with all PET studies, including the DOTATATE PET items.

For an overview of the changes go to Diagnostic imaging and related changes effective 1 May 2020

Cancellation of the ANZSNM 50th Annual Scientific Meeting

The ANZSNM has announced the cancellation of the ANZSNM 50th Annual Scientific Meeting due to take place from 24-26 April 2020. This decision was mandated by the Federal Government Advisory that gatherings of over 500 people are not to proceed in response to COVID19. The NSW Government implemented this as a total ban effective from 15 March and in place until June 14 2020:
https://www.health.nsw.gov.au/Infectious/diseases/Documents/covid-19-public-events-order-20200315.pdf

On 18 March the Australian Government announced that non-essential indoor gatherings of more than 100 people have been banned.

Due to cancellation of the ANZSNM ASM in Sydney, the 2020 AANMS Fellows’ Dinner to be held at the Opera House in conjunction with that meeting was also cancelled. This was to a be a special event to celebrate the AANMS 50th Anniversary. The celebrations will be postponed to a future event.

Information on the cancellation is available on the ANZSNM website at https://www.anzsnm.org.au/news-events/2020-anzsnm-annual-conference/ and will be updated regarding the cancellation process including registration fees. AANMS will provide information to members when it is available.

ANSTO Scheduled Preventative Maintenance Shutdown

The Australian Nuclear Science and Technology Organisation (ANSTO) has scheduled a preventative maintenance shutdown of its nuclear medicine processing and distribution facility, also known as Building 23, from 14 April – 13 May.  They are also planning a preventative maintenance shut-down in the OPAL nuclear reactor from 1- 28 June.

ANSTO has in place contingency plans to make all products, with the exception of 123Sodium Iodine solution, available during the shut-down period.

ANSTO has advised that radiopharmaceutical supply is at risk during the COVID19 crisis. Relevant organisations, including the AANMS, will be in communication with ANSTO about the potential impact of the COVID19 on planning for the Building 23 and OPAL reactor preventative maintenance shutdowns.

Australian Meetings – 2020

NOTE: We will continue to keep this list updated, but please check with the organising body before making any plans.

ANZSNM 50th Annual Scientific Meeting
VIRTUAL ASM now running – including 2020 AANMS Registrar Research Award Live Session, 10 July 2020, 10:30 AEST

The virtual ASM will comprise a mix of live-stream and on demand recorded sessions.  For updates and to register please see https://www.anzsnm.org.au/events/ASM2020/

The 2020 AANMS Registrar Research Award presentations live session will run on Friday 10 July from 10:30 AEST; you can download a schedule of the presentations.

The 2021 ANZSNM ASM will be held in Sydney over 22 – 24 May 2021.

Royal Australasian College of Physicians Congress
CANCELLED
www.racpcongress.com

Medical Oncology Group of Australia Annual Scientific Meeting
POSTPONED – no new date set
Please check website for latest updates:
https://www.moga.org.au/SitePage/fullwidth/annualscientificmeeting

Cardiac Society of Australia and New Zealand 68th Annual Scientific Meeting
RESCHEDULED to 10-13 December 2020
Gold Coast Convention and Exhibition Centre
www.csanzasm.com

Royal Australian and New Zealand College of Radiologists 71st Annual Scientific Meeting
POSTPONED to 2021
https://www.ranzcr2020.com/

Australasian Society for Ultrasound in Medicine 50th Anniversary Conference
POSTPONED
www.asum.com.au/asum2020-conference-news


International Meetings – 2020

SNMMI Annual Meeting
VIRTUAL ONLINE MEETING

11 – 14 July 2020
https://am.snmmi.org/imis/SNMMI-AM/SNMMI-AM/Home.aspx

EANM 33rd Annual Congress
UNCHANGED

17 – 21 October 2020
Austria Center, Vienna, Austria
https://eanm20.eanm.org/

RSNA Annual Meeting
VIRTUAL MEETING – registration opens 22 July 2020

29 November – 4 December 2020
McCormick Place, Chicago, IL USA
rsna.org/annual-meeting