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Good news for Medicare & Medicaid recipients...Now they'll pay for low-dose CT scans to look for lung tumors for patients at high risk

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On Monday, the Center for Medicare & Medicaid Services (CMS) made a formal proposal to start paying for low-dose CT scans to look for lung tumors for people with a high risk. This is a mode that advocates say could save thousands of lives every year by catching the disease earlier. The decision is currently open for a 30-day comment period.

Lung cancer is the world’s No. 1 cancer killer. Lung cancer is so deadly because it doesn’t cause symptoms until it’s already spread. According to the American Cancer Society, it kills nearly 160,000 people a year. The idea of screening people and catching the cancer early is interesting.

According to the CEO of Lung Cancer Alliance, this decision has the potential of being one of the most significant cancer mortality-reducing efforts to date.

Currently, many private insurers already pay for lung cancer screening.

The U.S. Preventive Services Task Force recommends that heavy smokers who are at least 55 years old should have an annual CT scan to check for lung cancer. This recommendation could apply to about 9 million Americans.

The screening test, which costs $250 - $300, may prevent as many as 20% of future deaths from lung cancer. This makes it akin to mammograms and colonoscopies in terms of saving living.

A study published last May projected that lung cancer screening would cost Medicare $9 billion over 5 years, or about $3 per month per beneficiary.

CMS will cover people ages 55 to 74 who have smoked at least a pack a day for 30 days or the equivalent.

Using CT scans for cancer isn’t cheap and it isn’t harmless. The spiral CT that is used to look for lung cancer is a low-dose form of X-ray, which delivers about the same radiation as a mammogram. The scans aren’t always clear. A fuzzy blur on a CT scan could be a tumor, emphysema, an infection or even nothing. Doctors often recommend a second scan if there’s something suspicious on the first scan.


Category: Misdiagnosis and Failure to Diagnose

Gerry Oginski
NY Medical Malpractice & Personal Injury Trial Lawyer

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