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Medicare Announces Proposal to Cover Lung Cancer Screenings

Update Date: Nov 11, 2014 09:21 AM EST

Medicare announced its new plan to cover lung cancer screenings for current or ex-heavy smokers. According to the Centers for Medicare and Medicaid Services (CMS), patients who meet the criteria as high-risk beneficiaries, determined by their doctors, can start receiving coverage for annual scans as early as next year.

"The American Lung Association applauds Medicare for this lifesaving announcement," Harold Wimmer, national president and CEO of the lung association, said in a statement reported by Philly. "Today's proposal by Medicare will save lives, increasing the low survival rates associated with lung cancer, our nation's leading cancer killer."

Lung cancer is extremely deadly because it is often detected too late. A recent study found that low-dose CT scans could cut high-risk patients' chances of dying from cancer by 20 percent. The U.S. Preventive Services Task Force now recommends at-risk people between the ages of 55 and 80 to get the test. Despite this recommendation, Medicare did not offer coverage for the scans, which can cost anywhere from $100 to $400.

The latest proposal offers coverage based on the several factors. First, the patient has to be considered high-risk for lung cancer by his/her doctor. Risk can be determined by how much a patient smokes. High-risk individuals will have a smoking history of 30 packs per year. Second, the patient has to be a current smoker or had quit the habit within the past 15 years. Third, prior to the CT scan, the patient must receive information and counseling on the pros and cons of undergoing a screening test. Fourth, the patient must be between the ages of 55 and 74.

"Tens of thousands of lives will be saved by providing America's seniors with fair and equitable access to the same lifesaving lung cancer screening that is now being offered to those with private insurance," said Laurie Fenton Ambrose of the Lung Cancer Alliance, reported by CBS News.

As a part of the proposal, the CMS will require participating centers to submit all of the data they accumulate, ranging from CT screening findings to patient outcomes. The agency added that the radiologists must have adequate experience in reading CT scans for lung cancer and the radiology imaging centers must have experience with lung cancer screening or be accredited as an advanced diagnostic imaging centers.

The proposal will be open for public comment for 30 days. The final decision will be made by February.

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