The Centers for Medicare & Medicaid Services (CMS) is expanding coverage for low-dose CT lung cancer screening, drawing praise from the American College of Radiology (ACR) and others.
CMS’ final decision will expand eligibility for Medicare beneficiaries to receive such lifesaving screenings by dropping the starting age from 55 down to 50 years old. The agency will also reduce the tobacco smoking history threshold from at least 30 pack-years down to 20, according to an announcement.
“Expanding coverage broadens access for lung cancer screening to at-risk populations,” CMS Chief Medical Officer and Director of the Center for Clinical Standards and Quality Lee Fleisher, MD, said Feb. 10. “Today’s decision not only expands access to quality care but is also critical to improving health outcomes for people by helping to detect lung cancer earlier.”
Imaging advocates praised the decision on Friday, calling it a “major step forward in lung cancer screening.” Those requesting the national coverage determination from CMS included the GO2 Foundation for Lung Cancer, Society of Thoracic Surgeons, and the American College of Radiology. All three groups said they will work with the federal government, medical providers and patients to implement and update screening recommendations.
“Expanded lung cancer screening access can help doctors hit back against the nation’s leading cancer killer and ease lung cancer outcomes disparities — particularly among women, Black men and those in rural areas,” Debra Dyer, MD, chair of the ACR Lung Cancer Screening Steering Committee, said Feb. 11.
In addition, the final decision will also simplify requirements for counseling and shared decision-making as part of screening. Based on feedback from the imaging field, CMS is removing stipulations that the reading radiologist must document participation in continuing medical education, “thereby reducing administrative burden on providers,” according to the announcement. The agency also expanded coverage to thousands of independent diagnostic testing facilities nationwide, ACR noted, and retained a requirement that providers use Lung-RADS structured reporting.
The feds first announced they were launching a process to consider expanding coverage for LDCT in May 2021. In a follow-up announcement last November, CMS hinted at Thursday’s forthcoming decision, indicating that the evidence was sufficient to expand Medicare coverage.
Read the full final decision from the Centers for Medicare & Medicaid Services here.
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Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.