Conducting exams to detect the early stages of diseases is beneficial to patients but can be expensive for physicians. However, after months of deliberation from federal agencies, relief has finally come for doctors who perform lung cancer screenings with computed tomography.
According to AuntMinnie.com, the U.S. Centers for Medicare and Medicaid Services announced that it would reimburse medical imaging facilities for lung cancer screenings conducted on patients up to the age of 74. Many advocates believed that Medicare payments were necessary, as older individuals 65 years and older are most susceptible to the disease and would benefit the most from screenings.
What happens now?
Back in April, the Medicare Evidence Development and Coverage Advisory Committee gave low-dose CT lung cancer screenings a low-confidence vote in terms of its efficacy, FierceMedicalImaging reported. However, that never stopped supporters, such as the Lung Cancer Alliance and the American College of Radiology, from lobbying for financial assistance from CMS.
"Lung cancer will kill 160,000 Americans this year – more than breast, colon and prostate cancers combined," Ella Kazerooni, chair of the ACR Lung Cancer Screening Committee, said in an announcement. "Medicare coverage of these exams helps complete the first major blow against this terrible disease."
While CMS' announcement is a victory, its decision to cap patient age at 74 excludes thousands of people who are equally at risk. AuntMinnie.com explained that individuals who have already had cancer are not eligible for the screenings, nor are seniors aged 75 and older on Medicare. In addition, patients with chronic obstructive pulmonary disease will not be reimbursed for screenings.
How are radiologists affected?
Much like patients, who have to fit into certain categories to be eligible for LDCT screenings for lung cancer, radiologists must meet specific criteria to participate in these exams. FierceMedicalImaging reported that diagnostic imaging providers must be certified by the American Board of Radiology, have documented training in radiation safety and been involved in the interpretation of at least 300 chest CT scans over the last three years.
Health care facilities have to submit data to a national registry approved by CMS for each screening performed and use an effective low radiation dose during exams. With the new ruling, CT lung cancer screenings will transition from a specialty exam to a common test ordered by primary care physicians.
Contact Viztek for more information.
Ronny Bachrach
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