In another move toward Medicare payment for CT lung cancer screening, the U.S. Centers for Medicare and Medicaid Services (CMS) on February 10 opened up a 30-day public comment period regarding a proposal to make CT screening for high-risk individuals one of Medicare's covered preventive services.
The move follows a recent recommendation by the U.S. Preventive Services Task Force (USPSTF) in favor of lung cancer screening with low-dose CT. CMS said the public comment period began February 10 and ends March 12, 2014. To comment, click here.
CMS also said it will convene a Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) meeting in April to review the available evidence on lung cancer screening.
In explaining its decision to evaluate lung cancer screening as an "additional preventive service," CMS noted its acceptance of two formal requests to initiate a national coverage analysis (NCA) of lung cancer screening with low-dose CT. USPSTF recommended the exam last December 31 with a grade B recommendation for individuals at high risk of the disease based on their smoking history.
USPSTF recommends annual screening for lung cancer with low-dose CT in individuals ages 55 to 80 who have a minimum smoking history of 30 pack-years or who have quit within the past 15 years. According to the agency, screening should be discontinued once the individual has not smoked for 15 years or develops a health problem significantly limiting either the individual's life expectancy or his or her ability or willingness to undergo curative lung surgery.
CMS said the requests to perform the NCA came from Dr. Peter Bach, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, and Laurie Fenton Ambrose, president and CEO of the Lung Cancer Alliance.
Between now and April, as CMS gathers information from public comments and the MEDCAC meeting, the agency is especially interested in information covering certain aspects of lung cancer screening, such as the following:
- The identification of patients eligible for screening
- The appropriate frequency and duration of screening
- Facility and provider characteristics that predict benefit or harm
- Precise criteria for test positivity
- The effect of false-positive results and follow-up tests or treatments
"We are also soliciting input on the influence of these factors on patient education and informed consent in Medicare beneficiaries including the elderly and younger disabled populations and persons receiving dialysis treatment for end-stage renal disease; and on the integration of smoking cessation interventions for current smokers," the agency noted.
