The Centers for Medicare & Medicaid Services (CMS) has initiated a national coverage analysis for the use of screening CT colonography (CTC) for colorectal cancer, which will evaluate the available evidence for screening CTC and determine if a national coverage determination is warranted.
CMS currently covers colorectal cancer screening for average risk individuals age 50 and older using fecal occult blood testing, sigmoidoscopy, colonoscopy and barium enema.
However, on March 5, the American Cancer Society, the U.S. Multi Society Task Force on Colorectal Cancer and the American College of Radiology (ACR) issued new cancer screening guidelines, including a recommendation that CTC be considered an acceptable option for colorectal cancer screening for such individuals.
According to the ACR, neither the Medicare law nor the regulations identify the CTC test as a possible coverage option under the colorectal cancer screening benefit.
However, CMS is allowed, under 42 CFR 410.37(a)(1), to use the national coverage determination process to determine coverage of other types of colorectal cancer screening tests that are not specifically identified in the law or regulations as it determines to be appropriate, in consultation with appropriate organizations.
CMS said it is seeking and will consider all public comments. The agency noted that it is particularly interested in clinical studies and other scientific information related to the technology under review; and as to the types of studies needed, if the evidence is determined to be premature for coverage or if the appropriate frequency interval is uncertain.
CMS has urged that all public comments be submitted here, regarding the coverage of screening CTC in colorectal cancer care.
The public has until June 18 to submit comments regarding this topic.