News in brief - May 12, 2003

Medicare broadens PET coverage - First verdict under Texas HMO liability law is upheld - Physician named to CMS medical post

Medicare broadens PET coverage

The Centers for Medicare & Medicaid Services will expand its coverage of positron emission tomography to include Medicare beneficiaries with thyroid cancer and those who might have cardiac disease. PET scans are already covered for diagnosis, staging and restaging of several cancers.

CMS also is designing a demonstration to evaluate use of PET for patients with suspected dementia. The agency will work with the National Institutes of Health and others to explore the value of the scans for patients with Alzheimer's disease. Information on Medicare coverage decisions for PET is available at CMS's Web site (www.cms.hhs.gov/ncdr).

First verdict under Texas HMO liability law is upheld

A $13.6 million jury award against an HMO in Texas will be allowed to stand -- the first verdict under the state's HMO liability statute.

In April, a Texas judge denied CIGNA Healthcare of Texas' request for a new trial and a reduction in the jury verdict awarded in June 2002.

The case, Dorothy Pybas, et al. v. CIGNA Healthcare of Texas, charged that the plan wrongly pushed 83-year-old Hershel Pybas out of a skilled nursing facility to cut costs in disregard of his serious medical condition. He died several days later.

Physician named to CMS medical post

Sean Tunis, MD, has been appointed chief medical officer and director of the Office of Clinical Standards and Quality for the Centers for Medicare & Medicaid Services. He had served as the agency's acting chief medical officer for almost a year.

Dr. Tunis is a practicing emergency physician in Baltimore and holds an adjunct faculty position in the Dept. of Medicine at the Johns Hopkins School of Medicine.