News | Lung Imaging | September 14, 2016

Proposed cuts would decrease reimbursement 64 percent for low-dose computed tomography shared decision-making sessions and 44 percent for LDCT scans themselves

LDCT scans, lung cancer screening, CMS, proposed reimbursement cuts, ACR, Congress

September 14, 2016 — The American College of Radiology (ACR) applauded members of the House Ways and Means Committee for standing against planned cuts to Medicare reimbursement for low-dose computed tomography (LDCT) lung cancer screening. According to the ACR, this exam is the first and only cost-effective test proven to significantly reduce lung cancer deaths.

In a recent letter to the Centers for Medicare & Medicaid Services (CMS), Reps. Jim Renacci (R-OH), Dr. Charles Boustany (R-LA), Richie Neal (D-MA) and Bill Pascrell, Jr. (D-NJ) expressed opposition to the drastic cuts included in the 2017 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule.

The congressmen told CMS, “In light of recent policy changes that would expand access to life-saving screening services, we write to specifically raise concern that these proposed reimbursement cuts to screening services will only serve to undermine the recent progress…[we] respectfully request that CMS reconsider these proposed cuts.”

These concerns echoed those of the ACR and more than 80 patient advocacy groups, medical associations and healthcare systems. These groups recently warned CMS that proposed cuts to reimbursement for LDCT shared decision making sessions and LDCT scans of 64 and 44 percent, respectively, may scuttle recently established screening programs and deter local providers from starting screening programs.

“As Medicare and the healthcare delivery system place greater emphasis on preventive medicine and population screening in order to prevent further costs in the future, we urge you to consider the impact that these cuts may have on lung cancer screening and diagnosis,” said the congressmen.

CMS moved to provide lung cancer screening coverage for high-risk patients in 2016, largely based on United States Preventive Services Task Force (USPSTF) recommendations. However, the proposed reimbursement cuts would likely restrict screening to large metropolitan hospitals. Those in suburban and rural areas may face longer commute and wait times to be screened — if they can gain access to screening at all.

“We are disappointed that these payment cuts were proposed after USPSTF and Medicare granted greater access to this important screening procedure and we want to ensure that the goal of increased access to lung cancer screenings is realized,” added the Ways and Means Committee members.

More than 220,000 people will be diagnosed with lung cancer this year. Nearly 160,000 people will die from the disease — more than from breast, colon and prostate cancers combined.

“We are pleased these congressmen want to protect access to lung cancer screening. These exams can save more lives than any cancer test in history, but only if patients have ready access to them,” said James A. Brink, M.D., FACR, chair of the American College of Radiology Board of Chancellors. “These cuts would pull the rug out from under emerging screening programs and may contribute to unnecessary lung cancer deaths,” added Brink.

For more information: www.radiologyinfo.org


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