Following months of anticipation, CMS has put aside MEDCAC's vote of low confidence in favor of approving reimbursement for lung-cancer screening with low-dose CT for high-risk Medicare beneficiaries.
For those who fought long and hard to show the safety, efficacy and cost-effectiveness of the screenings—along with infrastructure and quality-assurance programs to support screening—the news is decidedly good.
The evidence, said CMS in its Nov. 10 decision summary posted online, “is sufficient to add a lung cancer screening counseling and shared decision making visit, and, for appropriate beneficiaries,” once-per-year screenings “as an additional preventive service benefit under the Medicare program.”
The proposed decision summary presents detailed criteria beneficiaries must meet to qualify for the screenings as well as eligibility criteria for radiologists and imaging centers interested in providing the service to Medicare beneficiaries.
The American College of Radiology quickly issued a press release lauding the decision.
“This is a great day for those at high-risk for lung cancer and their families,” said Ella Kazerooni, MD, chair of the ACR’s lung cancer screening committee and an outspoken proponent of the screenings over the months leading up to decision day. “We look forward to a future where a lung cancer diagnosis is no longer essentially a death sentence for so many people.”
The ACR also said it will apply to be a Medicare-recognized registry, one of the eligibility requirements for participation by providers, and will work with stakeholders to submit comments regarding the details of the CMS coverage announcement.