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World/National News

June 18, 2014

Lawmakers urge Medicare coverage for cancer test

WASHINGTON (AP) — More than 130 lawmakers are urging the Obama administration to expand coverage for a lung-cancer test under Medicare that could cost the program billions, calling the screening important for vulnerable seniors.

In a letter to the Centers for Medicare and Medicaid Services, the lawmakers called for a timely decision on coverage for low-dose CT scans for older patients at higher risk of developing lung cancer.

The U.S. Preventive Services Task Force last December recommended the test for people ages 55 through 79 who smoked a pack of cigarettes a day for 30 years, or the equivalent. That’s about 10 million Americans. The low-dose CT scan will be covered by private insurance as required by the Affordable Care Act with no copays, beginning Jan. 1.

But the new health care law doesn’t require Medicare to cover the screenings, which cost $100 to as much as $400. CMS is reviewing the proposal, with a preliminary decision expected by November.

“Americans pay into Medicare throughout their working lives and deserve to have access to potentially life-saving evidence-based screenings that can prevent further health costs down the road,” according to the letter.

The letter was led by Reps. Jim Renacci, R-Ohio; Richard Neal, D-Mass; Charles Boustany, R-La. and John Barrow, D-Ga. It was signed by 130 other lawmakers.

A CMS spokesman said the agency’s decision will be based on whether the test is “reasonable and necessary,” without regard to its cost to Medicare. He declined additional comment until the agency responds to lawmakers.

Lung cancer is the world’s top cancer killer, with more than 156,000 U.S. patients dying each year, mainly because it’s usually found too late for treatment to do much good. In Ohio, about 4,200 die annually from lung cancer. Most deaths involve Medicare-age people, and most are due to smoking.

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