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NOPR Background
The National Oncologic PET Registry (NOPR) was developed in response to the Centers for Medicare and Medicaid Services proposal to expand coverage for positron emission tomography with F-18 fluorodeoxyglucose (PET) to include cancers and indications not presently eligible for Medicare reimbursement. Medicare reimbursement for these cancers can now be obtained if the patient's referring physician and the provider submit data to a clinical registry to assess the impact of PET on cancer patient management. The NOPR is implementing this registry for CMS. The NOPR is sponsored by the Academy of Molecular Imaging and managed by the American College of Radiology through the American College of Radiology Imaging Network.
The NOPR received input from, and is endorsed by the ACR, the American Society for Clinical Oncology, and the Society for Nuclear Medicine.
NOPR Status Update
The NOPR began accepting facility registrations in late November 2005 and patient registration began on May 8, 2006.
How to Register as a Participating Site
Any PET facility that is approved to bill CMS for either technical or
global charges can apply to participate in the NOPR. Sites are not
required to have ACR or ICANL accreditation to participate. Interested
facilities will register via the Facility Registration tool on the NOPR Web site, www.CancerPETregistry.org.
The facility will complete the Facility Pre-Registration and
Registration Forms online through the PET Facility Registration link.
After completing the Registration process the facility
must send an executed ACR HIPAA Business Associates Agreement (BAA)
to NOPR
Headquarters at 1818 Market Street, Philadelphia, PA 19103. The ACR
HIPAA BAA is available on the NOPR Web site under Sample Forms. NOPR
will assign a facility ID number and send an invoice for the facility
registration fee ($50) and the escrow account (amount determined by the
facility).
How to Register as a Participating Site
Any PET facility that is approved to bill CMS for either technical or
global charges can apply to participate in the NOPR. Sites are not
required to have ACR or ICANL accreditation to participate. Interested
facilities will register via the Facility Registration
tool on the NOPR Web site, www.CancerPETregistry.org.
The facility will complete the Facility Pre-Registration and
Registration Forms online through the PET Facility Registration link. After completing the Registration process the facility
must send an executed ACR HIPAA Business Associates Agreement (BAA)
to NOPR
Headquarters at 1818 Market Street, Philadelphia, PA 19103. The ACR
HIPAA BAA is available on the NOPR Web site under Sample Forms. NOPR
will assign a facility ID number and send an invoice for the facility
registration fee ($50) and the escrow account (amount determined by the
facility).
Patient Eligibility
Medicare beneficiaries who are referred for PET for essentially all oncologic indications that are not currently reimbursable under Medicare are eligible to participate in the NOPR. The Indications table lists the cancers and indications that will be accepted in the Registry.
PET Facility Responsibilities
The PET facility is responsible for collecting and entering patient data into the Registry database through a web application at www.CancerPETregistry.org. Below is a brief summary of the data collection procedure.
- When a patient eligible for entry into the NOPR presents at the PET facility, the facility contacts the referring physician and obtains confirmation that the referring physician will submit the pre- and post-PET data requirements.
- The facility registers the patient on the NOPR via a Web form, at which time a Registry case number is assigned.
- The NOPR will e-mail confirmation to the PET facility and at the same time e-mail a request for the pre-PET form to the PET facility for delivery to the referring physician.
- The referring physician must complete and return the Pre-PET Form to the PET facility and the PET facility must enter the Pre-PET Form into the NOPR database by midnight of the day of the PET scan.
- At some time before the PET study, or when the patient arrives for the PET scan, the PET facility will provide the patient with the ACR IRB-approved standard NOPR Patient Information Sheet that is posted on the NOPR Web site. The patient will be able to contact the NOPR directly for more information, if necessary. The patient will indicate his or her consent verbally to staff at the PET facility, either on the day of the PET study or within two working days after the PET study is completed. Written consent is not required. The PET facility will note in the database and on the PET Report Form, if the patient gave or withheld consent for use of his or her data in future NOPR research.
- After the PET scan is performed, the PET facility sends the PET report to the referring physician, enters the study completion date into a Web form, and submits the report text electronically to the NOPR database. Note that the PET scan must be completed and the PET Scan Completion Form must be entered into the database within 14 days of case registration or the case will be marked as ineligible.
- After the PET Scan Report Form is entered, the database will send the PET facility a patient-specific Post-PET Form
for delivery to the referring physician. This form will also include an ACR IRB-approved Referring Physician Information Sheet. The physician will indicate on the Post-PET Form whether consent for use of the response data in future NOPR research has been given or withheld. All data will be sent to CMS, but the dataset used by NOPR investigators for research will contain only the data of patients and physicians when both have consented to have the data included. This form must be completed, returned to the PET facility, and entered into the NOPR database within 30 days of the PET scan.
Referring Physician's Responsibilities
The patient's referring physician must agree to complete pre- and post-PET data collection forms consisting of approximately 5 questions regarding the patient's planned management.
- The Pre-PET Form must be completed by the referring physician and returned to the PET facility prior to the patient's PET scan. A blank Pre-PET Form can be
downloaded from the NOPR Web site and sent to the PET facility at the time of patient referral. If the form is not submitted with the referral a patient-specific form will be e-mailed to the PET facility for delivery to the referring physician. The Pre-PET Form can be returned to the PET facility via, FAX, mail, or hand delivery.
- After the PET is performed a patient-specific Post-PET Form will be e-mailed to the PET facility for delivery to the referring physician for completion within 30 days. This form will also include an ACR IRB-approved Referring Physician Information Sheet. The physician will indicate on the Post-PET Form whether consent for use of the response data in future NOPR research has been given or withheld. All data will be sent to CMS, but the dataset used by NOPR investigators for research will contain only the data of patients and physicians when both have consented to have the data included. This form can also be returned to the PET facility via FAX, mail, or hand delivery.
The case is eligible for CMS reimbursement only if the Pre-PET Form is completed and returned to the PET facility prior to the PET scan and the Post-PET Form is completed and returned within 30 days of the PET scan.
How to Obtain Medicare Reimbursement
The NOPR database will notify the PET facility when all case data have been entered. The PET facility can then bill CMS for the study. The PET facility can check on the case status of their patients at any time via the reporting tools available on the NOPR Web site.
Sponsored by:
- Academy of Molecular Imaging
Endorsed by:
- American College of Radiology
- American Society of Clinical Oncology
- Society for Nuclear Medicine
Managed by:
- American College of Radiology
- American College of Radiology Imaging Network
Advisor:
- Centers for Medicare & Medicaid Services
NOPR Working Group
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