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Pressure Builds For CT Lung Screening Coverage

June 19, 2014
Written by: , Filed in: Chest Radiology, Practice Management
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The pressure seems to be building on the Centers for Medicare & Medicaid Services (CMS) to have Medicare pay for annual low-dose CT lung cancer screening for older at-risk adults.

Both the U.S. Senate and the U.S. House of Representatives have sent letters to CMS backing the coverage. The Senate letter had Senators Dianne Feinstein, D-California, and Johnny Isakson, R-Georgia, as lead signatories and 42 co-signers. The House letter had 134 signatories, led by Representatives Jim Renacci, R-Ohio, Charles Boustany Jr., MD, R-Louisiana, John Barrow, D-Georgia, and Richard Neal, D-Massachusetts.

The House letter concluded with the following:

Americans pay into Medicare throughout their working lives and deserve to have access to potentially life-saving evidence-based screenings that can prevent further health costs down the road.

On Tuesday, a pro-screening opinion piece headlined “Medicare’s Puzzling Refusal to Cover Lung-Cancer Screening” appeared in the Wall Street Journal. Co-authors are Douglas E. Wood, MD, professor and chief of cardiothoracic surgery at the University of Washington, and Ella A. Kazerooni, MD, professor of radiology at the University of Michigan and chair of the American College of Radiology‘s Committee on Lung Cancer Screening.

Last week, the International Association for the Study of Lung Cancer reported on two new studies, both of which are to be published in the July Issue of the Journal of Thoracic Oncology. One found good patient compliance rates and survival outcomes using a five-year low-dose CT screening protocol. The other found that lung cancer screening did not appear to be associated with long-term distress, worry, or negative health-related quality of life.

Back in December, the U.S. Preventive Services Task Force issued a Grade B recommendation for annual low-dose CT lung cancer screening of adults ages 55 to 80 who have a 30-pack-year smoking history and currently smoke or have quit during the past 15 years. Under the Affordable Care Act (ACA), that triggers automatic coverage by private insurers without a co-pay, starting January 1.

However, the ACA does not require Medicare to do the same. At the end of April, the Medicare Evidence & Coverage Advisory Committee voted against recommending Medicare coverage for the screening.

CMS is currently taking public comments on two formal requests to cover the screening. It is expected to issue a proposed decision by November and a final decision in February 2015. Stay tuned.

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