Coalition Calling for Medicare Coverage of CT Lung Cancer Screening Grows

More than 60 patient advocacy and medical organizations have joined a coalition headed by the Lung Cancer Alliance, the American College of Radiology and The Society of Thoracic Surgeons, in urging Medicare to cover low dose computed tomography (LDCT) screening for beneficiaries at high risk for lung cancer.

In a new joint letter to the Centers for Medicare & Medicaid Services (CMS), the coalition, which now includes the American Cancer Society, American Cancer Society Cancer Action Network and the American Society of Clinical Oncology, outlined conditions under which Medicare should cover the exams; verified quality control measures to ensure safe, equitable care; and asked Medicare to support existing data registries and screening infrastructure.

“The American Cancer Society carefully considered the evidence supporting screening for lung cancer with low dose CT scans and issued a guideline recommending screening for people at high risk based on age and smoking history. This vital new screening tool is required by law to be available to most individuals with commercial insurance, but not those covered by Medicare. It’s time to extend coverage to all who may benefit from screening,” says Richard C. Wender, MD, chief cancer control officer of the American Cancer Society.

The United States Preventive Services Task Force (USPSTF) recommended (with a Grade of “B”) LDCT lung cancer screening of adults aged 55-80 who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. The groups want CMS to provide full coverage for this high-risk group, support existing data registry coordination to track outcomes and provide coverage with evidence development for others at risk beyond those in the USPSTF recommendations.

LDCT screening significantly reduces lung cancer deaths, according to studies. The test works as well in people age 65 and over as it does in those 50-64. It has been shown to be cost effective in Medicare and privately insured patients. Published results show no undue or lasting patient anxiety from the exam results process.

The Affordable Care Act (ACA) requires private insurers to cover medical exams that receive a USPSTF grade of “B” or higher. The ACA does not specify that Medicare beneficiaries receive full coverage for these services. As it stands, the privately insured would have ready screening access, while Medicare beneficiaries remain at higher risk of lung cancer death due to lesser screening access.

“The time tested breast cancer screening framework has been readily adapted to enable safe, appropriate and high-quality lung cancer screening. It is time for Medicare to support this process by covering these exams so that we can bring this lifesaving technology to people at risk for lung cancer,” says Ella Kazerooni, MD, FACR, chair of the American College of Radiology Lung Cancer Screening Committee and American College of Radiology Thoracic Imaging Panel.
Source: ACR