In a draft decision, the Centers for Medicare & Medicaid Services (CMS) has announced it will provide Medicare coverage for low-dose computed tomography (LDCT) screening for seniors at high risk of lung cancer, the American College of Radiology (ACR) has announced.
Based on the findings of a National Lung Screening Trial (NLST), the United States Preventive Services Task Force (USPSTF) previously made a Grade B recommendation that LDCT lung cancer screening be provided to individuals aged 55 to 80 years old with a 30 pack-year smoking history, who currently smoke or have quit within the last 15 years. Under the Affordable Care Act, private insurers must cover LDCT lung cancer screening for their beneficiaries.
The CMS decision extends coverage to Medicare patients 55 to 74 years old, in alignment with the NLST patient population, with coverage due to take effect in late summer 2015 at the earliest. The agency will also require providers to submit clinical and follow-up data to an approved registry. The ACR plans to apply for status as a Medicare-recognized registry.
According to an ACR spokesperson, CMS has 90 days to accept comments on the decision before it becomes official. The ACR said it will work with other stakeholders to submit comments during that window. Given the high-profile support the screening procedure has received from organizations such as the Lung Cancer Alliance, the American Cancer Society Cancer Action Network, and the Society of Thoracic Surgeons, it seems very likely that coverage will move forward.
“Lung cancer will kill 160,000 Americans this year—more than breast, colon and prostate cancers combined,” said Ella Kazerooni, MD, chair of the ACR’s Lung Cancer Screening Committee and Thoracic Imaging Panel. “Medicare coverage of these exams helps complete the first major blow against this terrible disease. This is a great day for those at high-risk for lung cancer and their families. We look forward to a future where a lung cancer diagnosis is no longer essentially a death sentence for so many people.”
Development of necessary infrastructure is already underway, including the ACR’s Lung Cancer Screening Center Program, which enables facilities to apply for official designation as a screening center, as well as the ACR’s Lung-RADS initiative to standardize CT lung cancer screening reporting and management and support lung CT interpretation.
In a separate announcement, Gail Rodriguez, executive director of the Medical Imaging Technology Alliance (MITA), commended CMS for its proposal. “Research shows that LDCT scans for individuals at high-risk of lung cancer could save up to 20,000 lives per year. Given lung cancer is the leading cause of cancer deaths, implementation of annual LDCT scans will improve outcomes through early detection and drive down treatment costs. We encourage CMS to finalize this proposal so that Medicare beneficiaries can reap the benefits of this invaluable technology.”
To locate an ACR lung cancer screening center, visit the ACR facility search page.