Medicare helps fight against cancer by proposing to cover lung screenings

Medicare helps fight against cancer by proposing to cover lung screenings

With lung cancer killing nearly 160,000 Americans per year, screening those that are at a higher risk could help cut the mortality rate by 20 percent.

The Centers for Medicare and Medicaid Services (CMS) issued a proposed decision memo concluding that the evidence is sufficient to add benefits to the Medicare program for lung cancer screening.  In particular, the memo states that the benefits would include lung cancer screening counseling and a shared decision making visit, and for appropriate beneficiaries, screening for lung cancer with low dose computed tomography (LDCT), once per year, as an additional preventive service benefit under the Medicare program.

In order to utilize these benefits, the patient must be between 55 and 74 years of age, have no current signs or symptoms of lung cancer, have a smoking history of at least one pack per day for 30 years, and be a current smoker or have quit within the last 15 years.  At the end of 2013, the U.S. Preventive Services Task Force (USPSTF) issued an updated recommendation that adults aged 55 to 80 with a smoking history should receive lung cancer screening.

According to Bloomberg Businessweek, the proposal by CMS has been anticipated since the USPSTF updated their guidelines.  With lung cancer killing nearly 160,000 Americans per year, screening those that are at a higher risk could help cut the mortality rate by 20 percent.  In particular, many of the deaths from lung cancer are the result of tumors not being detected early enough.

Due to the USPSTF guidelines, health care reform laws would require private insurers to pay for these screenings.  However, the same requirement was not imposed on Medicare.  The scans can cost between $100 and $400, and advisers initially questioned whether screening would really be of benefit to seniors.  With this proposed change, an estimated 4 million Medicare recipients would be eligible for screening.

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