CMS will cover lung cancer screening for smokers, pleasing industry, medical associations

Laurie Fenton Ambrose, president and CEO of the Lung Cancer Alliance

The Centers for Medicare & Medicaid Services acted against the advice of its advisory committee by making a preliminary decision to offer Medicare reimbursement of CT scanning as a means of lung cancer screening among heavy smokers, earning the praise of groups like the Lung Cancer Alliance.

"CMS got it right," Laurie Fenton Ambrose, president and CEO of the Lung Cancer Alliance, told MedPage Today. "The time to move forward and educate those at risk, especially our seniors, is now."

In April, the Medicare Evidence Development & Coverage Advisory Committee voted against recommending the coverage of annual low-dose computed tomography (LDCT) scanning in high-risk individuals, but CMS decided to support it amid heavy pressure from medical associations and some congressional representatives.

The decision covers an annual exam for asymptomatic patients aged 55 to 74 who have a smoking history of at least 30 pack-years. The patient must be a current smoker or have quit within the last 15 years, CMS said. A written order for LDCT lung cancer screening from a "lung cancer screening counseling and shared decision-making visit" is also required.

"LDCT has been shown to reduce mortality when used to screen individuals who are at high risk for developing lung cancer because of their age and smoking history," Dr. Charles Powell, chief of pulmonary, critical care, and sleep medicine at Mount Sinai Hospital in New York City and chair of the American Thoracic Society's thoracic oncology assembly, said in a statement, according to Medscape. "While there is some risk of overdiagnosis, it is outweighed by the mortality benefit that has been demonstrated with screening targeted groups of high-risk patients."

The three main providers of imaging devices--GE Healthcare ($GE), Siemens, and Philips ($PHG)--all sell CT scanners.

The final decision is due in February 2015.

- here's the CMS announcement
- read the MedPage Today story
- here's Medscape's take (reg. req.)

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