The Centers for Medicare & Medicaid Services (CMS) has announced a final decision to cover annual low-dose computed tomography (LDCT) scans for Medicare beneficiaries who are at high risk for lung cancer.
Specifically, CMS will cover the exam for individuals age 55-77 years with a 30 pack-year smoking history and who currently smoke or have quit within the past 15 years. CMS will require providers to submit clinical and follow-up data to an approved registry. The American College of Radiology (ACR) Lung Cancer Screening Registry has applied for CMS approval to help providers efficiently meet those registry reporting requirements.
Professional societies and medical imaging industry organizations applauded the decision.
“This is a great day for those at high-risk for lung cancer and their families. Now, we can save tens of thousands of people each year from this terrible disease that now kills more women in wealthy countries than breast cancer,” said Douglas E. Wood, M.D., past president of The Society of Thoracic Surgeons.
“Medicare coverage of CT lung cancer screening will help screening programs nationwide save lives. 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,” said Ella Kazerooni, M.D., FACR, chair of the American College of Radiology Lung Cancer Screening Committee and American College of Radiology Thoracic Imaging Panel.
“This decision is a triumph for Medicare beneficiaries who are at high-risk for lung cancer and will now have access to life-saving scans,” said Gail Rodriguez, executive director of MITA. “Given the high bar CMS holds in making national coverage determinations, it is clear that the benefits of LDCT scans for those at high risk of lung cancer are indisputable. This decision comes at an important time in the battle against this devastating disease, as the American Cancer Society recently reported that lung cancer has overcome breast cancer as the number one killer of women in developed countries. Expanding access to this early detection tool is a step in the right direction.”
“Medicare got this right. 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,” said Laurie Fenton Ambrose, president and chief executive officer of the Lung Cancer Alliance (LCA).
The ACR wants to remind providers that a screening infrastructure is in place and growing to meet demand:
- The ACR Lung Cancer Screening Center program helps ensure these exams are provided safely and effectively
- ACR Lung-RADS™ standardizes CT lung cancer screening reporting and management, aids lung CT interpretation and supports outcomes monitoring
- The ACR and the Society of Thoracic Radiology, also created CT lung cancer screening practice parameters for the performance of these exams
- The LCA National Framework for Excellence in Lung Cancer Screening and Continuum of Care identifies medical centers that follow best practices using multidisciplinary teams and incorporate ACR requirements to screen safely and effectively.
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