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Medicare & Medicaid News

Medical and Patient Groups Call for Medicare Coverage of CT Lung Cancer Screening

Lung cancer kills more people each year than breast, colon and prostate cancers combined

March 13, 2014 - Last December, the United States Preventive Services Task Force (USPSTF) recommended screening of adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. Today a large number of medical and patient groups called on the Centers for Medicare & Medicaid Services (CMS) to provide Medicare coverage of low-dose computed tomography (LDCT) screening for patients defined in the USPSTF recommendations and others found to be at high-risk of lung cancer.

 

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The request was from the Lung Cancer Alliance, The Society of Thoracic Surgeons, American College of Radiology (ACR) and 38 other medical organizations and patient advocacy groups.

 “Lung cancer kills more people each year than breast, colon and prostate cancers combined. For each of these other three cancers, there are well established screening tests and programs," said Douglas E. Wood, M.D., immediate past president of The Society of Thoracic Surgeons.

"We strongly urge CMS to implement broad national coverage so that those at high risk, can be screened, providing the opportunity to save thousands of people each year from this terrible disease.”

The Affordable Care Act (ACA) requires that private insurers cover all medical exams or procedures that receive a grade of “B” or higher from the USPSTF without a co-pay. However, the ACA does not specify that Medicare provide full national coverage for beneficiaries.

“The USPSTF’s recommendation that made lung cancer screening an essential health benefit specifically included 65 to 80 year olds who are also part of the Medicare population,” said Lung Cancer Alliance President and Chief Executive Officer, Laurie Fenton Ambrose. “If Medicare does not extend full coverage for lung cancer screening to this population, the net effect will be a two tier system that leaves Medicare beneficiaries at greater risk of dying from lung cancer than those with private insurance. This cannot be right.”

National Lung Cancer Screening Trial results and those of other smaller international randomized controlled trials show that CT lung cancer screening significantly reduces lung cancer deaths. Screening for current and former smokers with LDCT is the only method ever proven to reduce lung cancer mortality in this high-risk population and it has also been shown to be cost effective.

“CMS should act on the USPSTF recommendation to provide national coverage for high-risk Medicare beneficiaries and support quality screening programs across the country. This would, for the first time, enable healers and patients to strike a major blow against the nation’s leading cancer killer,” said Paul Ellenbogen, M.D., FACR, chair of the American College of Radiology Board of Chancellors.

 

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