Feature | March 03, 2015 | Melinda Taschetta-Millane

Medicare CT Lung Cancer Screening Coverage a Victory for Patients

Recently, the Centers for Medicare and Medicaid Services (CMS) issued a final national coverage determination, effective immediately, that provides for Medicare coverage of screening for lung cancer with low dose computed tomography (LDCT). This screening gives at-risk seniors unprecedented access to care.  

“This is the first time that Medicare has covered lung cancer screening. This is an important new Medicare preventive benefit since lung cancer is the third most common cancer and the leading cause of cancer deaths in the United States,” said Patrick Conway, M.D., chief medical officer and deputy administrator for innovation and quality for CMS.

Medicare will now cover lung cancer screening with LDCT once per year for Medicare beneficiaries who meet all of the following criteria:

are between 55-77, and are either current smokers or have quit
smoking within the last 15 years;

have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years); and

receive a written order from a physician or qualified non-physician practitioner that meets certain requirements.

“Medicare got this right,” stressed Laurie Fenton Ambrose, president and chief executive officer of the Lung Cancer Alliance (LCA). “Screening coverage will help save thousands of seniors each year from the nation’s leading cancer killer. Screening programs can also help lower smoking rates. The process may even lead to better understanding of addiction as well as lung cancer in those who have never smoked.” 

On Feb. 5, The American Society for Radiation Oncology (ASTRO) issued a statement commending CMS’ decision. “CMS has taken a bold step that can potentially reduce the lung cancer mortality of patients at highest risk for lung cancer by nearly 20 percent,” said ASTRO Chair Bruce Haffty, M.D., FASTRO. “We are grateful for the additional opportunities that annual screening provides us to save hundreds of thousands of lives from lung cancer. This year in the United States, it is estimated that nearly 230,000 men and women will be diagnosed with lung cancer, and that there will be more than 160,000 deaths from lung cancer — more deaths than from breast, colon and prostate cancers combined. This highly effective annual screening is a critical and powerful tool that will enable us to diagnose patients earlier when treatments are most effective, and it will fortify our efforts to battle this destructive disease.”

This very well could be a game changer in the battle against lung cancer. “Medicare coverage of CT lung cancer screening will help screening programs nationwide save lives,” stressed Ella Kazerooni, M.D., FACR, chair of the American College of Radiology Lung Cancer Screening Committee and American College of Radiology Thoracic Imaging Panel. “If older current and former smokers and their doctors decide that screening is warranted, patients should seek out an ACR lung cancer screening center. Together, we will complete the first major blow against lung cancer.” 

For more information on CT lung cancer screening: http://bit.ly/1AzscyA

To find an ACR Lung Cancer Screening Center: http://bit.ly/1xptSFe

Lung Cancer Decision Memo: http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274

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