ACR Calls on MedCAC to Recommend Full Medicare Coverage for CT Lung Cancer Screening

April 25, 2014 — At an April 30 meeting, Ella Kazerooni, M.D., chair of the American College of Radiology (ACR) Committee on Lung Cancer Screening, will urge the 2014 Medicare Evidence Development and Coverage Advisory Committee (MedCAC), to recommend national Medicare coverage of low-dose computed tomography (LDCT) screening for patients at high risk for lung cancer.

In December 2013, the U.S. Preventive Services Task Force (USPSTF) recommended screening of asymptomatic 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. The ACR, the Lung Cancer Alliance, the Society of Thoracic Surgeons and 38 other medical organizations want CMS to provide full national coverage for high-risk patients as defined in the USPSTF and provide coverage with evidence for other high-risk patients not included in USPSTF recommendations using data collected through existing registries.

“Lung cancer kills more people each year than breast, colon and prostate cancers combined,” said Kazerooni. “For these other three cancers, there are well established and accepted screening tests and programs. MedCAC should recommend, and CMS should implement, broad national coverage for CT lung cancer screening so that those at high risk can be tested and thousands more people each year can be saved 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. 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.

“We strongly urge MedCAC to recommend that the Centers for Medicare & Medicaid Services (CMS) act on the USPSTF recommendation to provide national coverage for high-risk Medicare beneficiaries,” said Paul Ellenbogen, M.D., FACR, chair of the ACR Board of Chancellors. This would support screening programs across the nation, and, for the first time, enable providers and patients to strike back against the nation’s leading cancer killer. It is time for Medicare to support CT lung cancer screening.”

The ACR is committed to assuring the quality and safety of lung cancer diagnostic care throughout this coverage determination process.

For more information: www.cms.gov/live