Last week, CMS announced that it would no longer reimburse for virtual colonoscopies, otherwise known as CT colonographies. While several large commercial health plans cover the procedure, including CIGNA and UnitedHealthcare, CMS said that it wasn't satisfied that this procedure improves health benefits "for asymptomatic, average risk Medicare beneficiaries."
Since CMS made its announcement, there has been a backlash among medical groups addressing the needs of cancer patients, including the American Cancer Society--which recently added CT colonography to its list of recommended colorectal cancer screens--the Colon Cancer Alliance and the American College of Radiology. "If let stand, this CMS decision not to pay for CT colonography will cost lives," said James Thrall, MD, chair of the ACR.
Colorectal cancer is the third most common cancer among both men and women in the U.S., with about 140,000 new cases diagnosed each year. Of those, about 50,000 people die because of late detection, Thrall notes.
To learn more about the debate:
- read this Health Leaders Media piece