Medicare policy sowing cancer screening confusion, American College of Radiology says
Medicare policies are sowing confusion about colorectal cancer screening, the American College of Radiology warned in a recent letter.
Starting Jan. 1 of this year, the key federal payment program begun covering CT-based screening for the disease, which followed years of advocacy by the specialty. The Centers for Medicare & Medicaid Services since then has issued coverage transmittals to providers on the topic. But it has yet to update the official colorectal cancer National Coverage Determination, ACR noted in an Oct. 1 news update.
The college is now urging Medicare to modify its policies to reflect expanded coverage for CTC. It also wants the agency to retire or remove the original noncoverage decision for the exam, which could help to “eliminate ongoing confusion.”
“These updates are critical to ensuring clarity, consistency and access to colorectal cancer screening options for Medicare beneficiaries,” ACR said in its update.
To plead the college’s case, CEO Dana H. Smetherman, MD, MBA, MPH, recently wrote to the agency. She noted that the original noncoverage decision (CAG-00396N) remains publicly available in the Medicare database, with the potential to mislead beneficiaries seeking information about CT screening.
“We believe these updates are essential to support appropriate access to colorectal cancer screening and to ensure consistency across CMS policy documents,” ACR wrote to Carl Li, MD, with the agency’s Coverage and Analysis Group, on Sept. 24.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.