The following post was contributed by Geraldine B. McGinty, MD, MBA, FACR
When an email from CMS pinged my inbox at 4 o’clock this past Monday I read with relief of Medicare’s decision that the evidence supports coverage of low-dose CT screening for lung cancer. I was delighted to see included in the Agency’s specifications for how they would like to see the program structured the rigorous quality elements that ACR had presented to them. I firmly believe that the team-based approach that ACR took in building a robust stakeholder coalition and our focus on “doing it right” was instrumental in helping the Medicare staff to make their decision in favor of coverage. But I’m not relieved because of the countless hours that we’ve all spent on this effort and because we “won.” No, I’m relieved because in just this past couple of weeks I have supported friends through the heartbreaking realization that they are going to lose a parent to lung cancer. I’ll be glad not to have as many of those conversations as we work to diagnose lung cancer earlier and save lives that would otherwise be lost to this terrible disease.
Is the decision perfect? As always, there are definitely areas on which we’ll comment. Cutting off coverage at 74 will leave many at-risk seniors without coverage for example and we have some concerns about the burden and cost associated with adding a visit as a precursor to every follow up CT, but we’re confident we can work with CMS to bring this important new program to fruition. Many of you will have questions on payment and rest assured our teams at ACR are scenario planning as I write to figure out the best solution for which to advocate on order to provide access for our patients and fair reimbursement for those who provide this lifesaving service. Stay tuned to the ACR website for more updates as CT lung cancer screening progresses.