Medicare Proposes to Cover Lung Cancer Screening for High-risk Patients

Lung cancer screenings for certain current or former heavy smokers, could soon be covered by Medicare.

The Centers for Medicare and Medicaid Services (CMS) recently released a proposal to cover low-dose CT lung cancer screenings, such as those offered at ProMedica, for certain high-risk patients.

The CMS announcement is welcomed news among lung cancer specialists.

“We’re focused on trying to catch lung cancer early and research shows screenings will help us do so,” said Ronald J. Wainz, MD, a pulmonologist with ProMedica Physicians. “Once a patient’s cancer becomes symptomatic – they start to cough up blood and have pain – the chance of a cure is very small.”

In order to qualify for the proposed CMS lung cancer screening coverage, patients must meet the following eligibility criteria:

–       Age 55 – 74 years

–       Have no signs or symptoms of lung disease

–       Have a tobacco history of smoking a pack a day for 30 years

–       Be a current smoker or one who has quit smoking within the last 15 years

–       Have a written order for the test from their healthcare provider and lung cancer screening counseling

“Screenings are designed for long-term smokers who may be at risk of having an early lung cancer that you can’t pick up on a chest x-ray,” said Dr. Wainz. “They would be asymptomatic and would not know they have lung cancer.”

If finalized, the CMS policy would be similar to the U.S. Preventive Services Task Force recommendation issued last December. It called for low-dose CT lung cancer screening for adults aged 55 – 80 who have a pack of day for 30 years smoking history and currently smoke or have quit within the past 15 years.

According to the American Cancer Society, lung cancer is the leading cause of cancer death among both men and women. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined.

A final decision on the CMS proposal is expected in February.