Last week, an advisory panel was convened by the Center for Medicare and Medicaid Services (CMS) to consider lung cancer screening for Medicare beneficiaries age 65 to 80. This panel, which offers non-binding advice to CMS, is referred to as a “MEDCAC.” None of the 14 panel members had direct experience with lung cancer screening and the committee was chaired by a doctor with an extensive anti-screening record. We were deeply disappointed by the process.
Recall from my earlier comments that late last year, the United States Preventive Services Task Force (USPSTF) completed its two-year review of evidence related to lung cancer screening and recommended that former and current heavy smokers between 55 and 80 undergo annual lung cancer screening. That recommendation by the USPSTF now makes lung cancer screening an Essential Health Benefit pursuant to the Affordable Care Act (ACA). By this time next year, nearly all private insurance plans will be required to provide coverage for lung cancer screening — without cost share or co-pay –for the USPSTF recommended population between ages 55 and 64.
Regrettably, because of our MEDCAC experience, I cannot help but worry that Medicare coverage for members of the USPSTF recommended population between ages 65 and 80 could be at risk. This is especially troubling because the majority of lung cancer cases are diagnosed in people over age 65.
As an invited speaker at the MEDCAC meeting, I had the opportunity to bring the patient’s perspective before the panel. I was joined by leading experts in the field of lung cancer screening and management including radiologists, thoracic surgeons, a physicist and oncologist, a health care economist, the chief medical officer from the world’s largest equipment manufacture and perhaps most compellingly, nurse coordinators from two of our Screening Centers of Excellence. Collectively, we painted a vivid picture of our direct, hands-on experiences and showed that lung cancer screening is already saving lives every day and that it can be implemented responsibly, safely, cost-effectively and equitably in community settings across the country.
Despite all of this testimony and the mounds of evidence submitted to the panel prior to the actual MEDCAC meeting, I was stunned by the ill-informed comments from some panel members. Those comments served as important reminders that not everyone is as current, well-informed or experienced in screening management as we are.
So what happens now? As I said in my MEDCAC testimony, for too long, a black cloud of despair and indifference has hovered over our community. But now, we have real hope for survival. And we are not going to let anything stand in our way!
This is just another bump in the long road that we have already successfully traveled together. We will continue to work with the amazing teams of health care professionals who are in the real world, working in real time, to help real people advance responsible screening across the country. Of course, we will work with you, too. In fact, we need your help now more than ever!
We must take our message directly to the President and let him know what’s at stake. Failure to provide Medicare coverage for lung cancer screening will mean that this lifesaving preventive service is an Essential Health Benefit for some, but not for our seniors. It will result in a patchwork healthcare system and lead to the ludicrous situation where someone could have coverage for screening at age 63 and 64, but be denied coverage at 65. It simply makes no sense.
We have created an online message that lays out the solid case for lung cancer screening for our at risk seniors. We ask that you CLICK HERE to sign it today. And please, spread the word!