WASHINGTON (AP) — More than 130 lawmakers are urging the
Obama administration to expand coverage for a lung-cancer test under
Medicare that could cost the program billons, calling the screening
important for vulnerable seniors.
In a letter to the Centers for
Medicare and Medicaid Services, the lawmakers called for a timely
decision on coverage for low-dose CT scans for older patients at higher
risk of developing lung cancer.
The U.S. Preventive Services Task
Force last December recommended the test for people ages 55 through 79
who smoked a pack of cigarettes a day for 30 years, or the equivalent.
That’s about 10 million Americans. The low-dose CT scan will be covered
by private insurance as required by the Affordable Care Act with no
copays, beginning Jan. 1.
But the new health care law doesn’t
require Medicare to cover the screenings, which cost $100 to as much as
$400. CMS is reviewing the proposal, with a preliminary decision
expected by November.
"Americans pay into Medicare throughout
their working lives and deserve to have access to potentially
life-saving evidence-based screenings that can prevent further health
costs down the road," according to the letter sent this month.
The
letter was led by Reps. Jim Renacci, R-Ohio; Charles Boustany, R-La.;
John Barrow, D-Ga. and Richard Neal, D-Mass. It was signed by 130 other
lawmakers.
A CMS spokesman said the agency’s decision will be
based on whether the test is "reasonable and necessary," without regard
to its cost to Medicare. He declined additional comment until the agency
responds to lawmakers.
Lung cancer is the world’s top cancer
killer, with more than 156,000 U.S. patients dying each year, mainly
because it’s usually found too late for treatment to do much good. In
Ohio, about 4,200 die annually from lung cancer. Most deaths involve
Medicare-age people, and most are due to smoking.
One major study
found that annual CT scans, a type of X-ray, could cut the chances of
dying from lung cancer by up to 20 percent in those most at risk —
people ages 55 through 79 who smoked a pack of cigarettes a day for 30
years.
A separate study released last month estimated that it
would cost Medicare $2 billion a year to offer the lung scans. Every
person covered by Medicare would shell out an additional $3 a month,
according to lead study author Joshua Roth of the Fred Hutchinson Cancer
Research Center in Seattle.
Tom Murphy, 62, of Woodbine, Md.,
says he believes older people should have access to the lung cancer
screening under Medicare. A former heavy smoker and Vietnam War veteran,
Murphy agreed to have the annual scans in 2005 under a trial program at
his local hospital. Doctors diagnosed him with lung cancer five years
later.
"For anybody who smoked previously, this is a very
important screening tool," Murphy said. "I believe had they not detected
my cancer early, I probably wouldn’t be here with my granddaughter
today."
Physician groups are somewhat divided.
The American
Academy of Family Physicians says the evidence is insufficient to
recommend for or against the CT screening. It says doctors and patients
must weigh the benefits and potential harm, such as radiation from
over-testing and false positive results.
But the American College
of Radiology says without Medicare coverage, seniors face "a two-tier
coverage system in which those with private insurance will be covered
for these exams and many of their lives saved, while Medicare
beneficiaries are left with lesser access." And at its annual policy
meeting last week, the American Medical Association agreed to support
efforts to gain Medicare coverage for low-dose CT screening in high-risk
adults, with a long history of smoking.
"The AMA believes
patients considered to be high-risk should receive coverage for
screening in order to increase their chance of surviving a lung cancer
diagnosis," AMA President Dr. Robert Wah said June 11 in a statement.
___
AP Medical Writer Lindsey Tanner in Chicago contributed to this report.