Medicare proposes to stop paying for virtual colonoscopies

CMS has announced that it wants to stop paying for Medicare coverage of virtual colonoscopies, otherwise known as CT colonographies. The agency says that it hasn't found enough evidence that these tests, which use X-ray images and computer software to create images of the colon, improve outcomes for Medicare beneficiaries.

A CMS analysis of available research found that while virtual colonoscopies are as good as traditional colonoscopies for detecting larger polyps, they aren't as effective where smaller polyps are concerned. Also, the agency noted that many of the prior studies supporting use of virtual colonoscopies used test subjects with an average age of 58, possibly suggesting that the results wouldn't apply to older Medicare beneficiaries.

CMS won't make a final decision on virtual colonoscopy coverage until after a 30-day comment period, but it seems likely that its tentative decision will become final, observers say.

To learn more about this issue:
- read this Kaiser Daily Health Policy Report item

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