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How Medicare Could Cover CT Screening for Lung Cancer — Physician’s First Watch

Medical News |
June 24, 2014

How Medicare Could Cover CT Screening for Lung Cancer

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and André Sofair, MD, MPH

A commentary in the Annals of Internal Medicine offers suggestions for how Medicare could safely and effectively cover lung cancer screening with low-dose computed tomography (LDCT) among heavy smokers.

Earlier in 2014, Medicare advisers issued a "low-confidence" vote on whether the benefits would outweigh the harms of screening in Medicare beneficiaries, even though the U.S. Preventive Services Task Force recommended screening high-risk groups in late 2013.

The author, a pulmonologist, says that in a worst-case scenario, Medicare could decline to cover the test entirely. A more palatable approach, she writes, would be for Medicare to cover the procedure when it's done at facilities with certified, patient-centered programs that could ensure only eligible patients are screened, offer smoking-cessation treatments, and maintain a patient registry.

She concludes: "To avoid the hard lessons learned from overzealous implementation of prostate cancer screening, we must get implementation of LDCT screening right from the outset. A [Medicare] determination that LDCT screening will only be covered in qualified facilities may provide the perfect opportunity to do so."

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