Mark your calendars for Wednesday, April 30. That’s the day that representatives from the American College of Radiology (ACR), the Lung Cancer Alliance and a number of other organizations will go before the 2014 Medicare Evidence Development and Coverage Advisory Committee (MedCAC) seeking to make the case for national Medicare coverage of low dose CT (LDCT) screening for patients at high risk for lung cancer.
The meeting comes after a December 2013 recommendation from the U.S. Preventive Services Task Force (USPSTF) that annual screening with LDCT be given to asymptomatic adults aged 55 to 80 who have a 30 pack-year smoking history and currently smoke or quit within the last 15 years.
The USPSTF’s recommendation was grade “B,” which under the Affordable Care Act means that private insurers must cover the procedure without a co-pay. The healthcare reform law, however, does not compel Medicare to provide full national coverage for such recommendations, setting the stage for next week’s meeting.
In the meeting notes posted online, the Centers for Medicare & Medicaid Services (CMS) said it would be particularly interested in evidence that would help identify which Medicare patients would most likely benefit from screening as well as the appropriate frequency and duration of screening. CMS also will be looking to understand the impact of false positive results and follow-up testing.
Hopefully Ella Kazerooni, MD, chair of the ACR Committee on Lung Cancer Screening, and others speaking in favor of coverage are up to the task, as full Medicare coverage of LDCT screening could save many lives. The results of the National Lung Screening Trial, which factored heavily in USPSTF’s recommendation, showed that CT lung cancer screening in a high-risk population can significantly reduce lung cancer deaths by as much as 20 percent.
We’ll be following the meeting live, and if you want to listen in, you can view the full-day discussion at http://www.cms.gov/live/ starting at 7:30 a.m. EDT on April 30.
Editor – Health Imaging