The agency announced it has drafted a reimbursement proposal to cover annual computed tomography (CT) scans for high-risk patients. High-risk patients are defined as individuals aged 55 to 74 years with a smoking history of 30 pack years who have quit smoking within the last 15 years.
Medicare will require people to undergo smoking cessation counseling or counseling on the importance of staying smoke-free prior to receiving the annual scan.
The agency will also require the following:
- Participating radiologists have solid experience in reading and interpreting CT scans for possible lung cancer
- The CT scans occur at a radiology imaging center with experience in lung cancer screening or accreditation as an advanced diagnostic imaging center
- Participating centers submit data on all CT screening findings, follow-up, and patient outcomes
Private insurers will also be required to cover lung cancer screenings for this group of people starting in 2015, the result of a recommendation issued almost a year ago by the United States Preventive Services Task Force.
The public will be allowed to submit comments to Medicare in response to the proposal until Dec. 10. A final announcement is expected next February, at which time coverage for Medicare beneficiaries will begin, according to the American Lung Association.