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CMS proposes 'drastic' cuts to LDCT lung cancer screening reimbursement

by Thomas Dworetzky, Contributing Reporter | September 07, 2016
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“For CMS to undercut lung cancer screening and restrict access to these exams with massive cuts accentuates disparities in health care delivery and undermines our ability to save thousands of lives,” said Dr. Douglas E. Wood, past president of The Society of Thoracic Surgeons.

CMS announced its final decision for coverage of LDCT for lung cancer in early February 2015. As HCB News reported at the time, “CMS will now reimburse annual LDCT lung cancer screening for individuals between 55 and 77 who are current smokers or who have quit smoking within the past 15 years and have a smoking history of at least 30 pack-years. They are required to get a written order for screening during a visit with a physician or a physician assistant, nurse practitioner or clinical nurse specialist.”

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At the time, Ambrose stated, "Today is a transformative moment. Lung cancer screening can now stand shoulder to shoulder with mammography, colonoscopy, pap smears and other proven cancer screenings that have saved countless lives," adding, "This signals a new day, where lung cancer transitions from the number one cancer killer to a treatable, even curable disease."

A U.K. study of screening in May showed that “if patients with a high risk of developing lung cancer are diagnosed at an early stage, then they have a 73 percent chance of surviving for five or more years.”

For the UKLS trial, researchers screened 1,994 patients with LDCT. They found that 42 had lung cancer, of which 36 were stage 1 or 2. A total of 35 of these patients had surgery as their primary treatment.

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