CT screening of the lungs of current and former heavy smokers is about to become a Medicare benefit.
A proposed decision published Nov. 10 has inserted some unprecedented conditions into its decision to cover screening:
Beneficiaries would have to go through counseling, and health professionals would be required to provide documentation that “shared decision-making” took place. The Centers for Medicare and Medicaid Services has never mandated shared decision-making as a gateway to paying for a service.
A coalition of patient advocacy and medical organizations urged the Centers for Medicare & Medicaid Services to cover low-dose computed tomography for Medicare patients at high risk for lung cancer.
More than 60 organizations—including the American Society of Clinical Oncology, the American Cancer Society and several cancer centers—signed a 43-page joint letter to CMS recommending unrestricted national coverage for annual screening.
The Centers for Medicare and Medicaid Services have another six months to decide whether to cover low-dose computed tomography screening. Yet, proponents of screening seem unwilling to take the chance that Medicare coverage would be restrictive.
To tilt the scale in their favor, they have launched two congressional sign-on letters to CMS.
National coverage for low-dose computed tomography may result in more harm than benefit to the Medicare population at this time, said Steven Woolf, a member of the Medicare Evidence Development & Coverage Advisory Committee.
Speaking at the April 30 MEDCAC hearing, Woolf said coverage would run into many implementation challenges and adherence problems—it would be unlikely that all practices would observe the strict criteria set by the U.S. Preventive Services Task Force and the National Lung Screening Trial, he said.
When it appeared that CT screening for lung cancer was a shoo-in for Medicare coverage, the Lung Cancer Alliance, an advocacy group, started to certify “screening centers of excellence.”
Centers all over the country received this designation from LCA and were listed on the group’s website.
However, as he prepared for a recent Medicare advisory committee meeting, Peter Bach, a pulmonologist and health systems researcher at the Memorial Sloan-Kettering Cancer Center, checked the list of LCA-certified centers.
The Cancer Letter asked Ella Kazerooni, a professor of radiology at the University of Michigan, chair of the American College of Radiology Committee on Lung Screening, and vice chair of the lung screening panel of the National Comprehensive Cancer Network, to lay out the rationale for a proposal for broad coverage for lung screening.
The Centers for Medicare and Medicaid Services is facing the formidable challenge of deciding what kinds of patients should be screened for lung cancer.
The agency’s Medicare Evidence Development & Coverage Advisory Committee will meet April 30 to decide how the positive findings of a large randomized trial and the recommendation the U.S. Preventive Services Task Force should be translated into policy.
The U.S. Preventive Services Task Force released its final recommendation statement on screening for lung cancer with low-dose computed tomography.
Annual LDCT screening can reduce lung cancer mortality of high-risk persons aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke, or have quit within the past 15 years, the 16-member task force determined.
President Joe Biden’s proposed Advanced Research Projects Agency-Health would be a welcome partner to NCI—particularly in conducting large, collaborative clinical investigations, NCI Director Ned Sharpless said.“I think having ARPA-H as part of the NIH is good for the NCI,” Sharpless said April 11 in his remarks at the annual meeting of the American Association for Cancer Research. “How this would fit with the ongoing efforts in cancer at the NCI is still something to work out.”