Minority groups join outcry over CMS’ rejection of CTC screening coverage

Members of the Congressional Black Caucus have joined the ranks of CT colonography advocates to pressure the Centers for Medicare and Medicaid Services to reverse a proposal to deny reimbursement for CTC screening. Proponents argue that the policy could widen existing colon cancer screening inequalities.

In a Proposed Decision Memorandum issued Feb. 11, CMS suggested that current scientific evidence is inadequate to conclude that CTC improves net health benefits for asymptomatic average-risk Medicare beneficiaries. CMS thus decided that CTC for colorectal cancer screening should remain uncovered.

This week, Rep. Danny K. Davis (D-IL) and 10 other members of the Congressional Black Caucus sent a letter to CMS' acting administrator Charlene Frizzera urging the agency to reconsider its CTC screening coverage proposal.

Colorectal cancer is the third most common cancer among African Americans, who deal with disproportionately high incidence and death rates. African Americans are less likely to receive recommended screening, however, and the invasiveness of the standard colonoscopy may be a contributing factor to the low rate of compliance, Davis explained in the letter.

Private insurance plans provide CTC screening coverage in 26 states, according to Davis. CMS' proposed decision, however, would deny that same access to Medicare beneficiaries in those states.

Findings of a study published recently in the Journal of the American Geriatrics Society showed that the disparity between white and nonwhite Medicare enrollees receiving colorectal cancer screening increased between 1995 and 2003.

"Medicare coverage of CTC as a minimally invasive screening test for colorectal cancer would not just encourage more patients to undergo screening, but it would potentially close or eliminate the gap in colorectal cancer screening between African American and other populations," Davis said.

The U.S. public overall is underscreened for colon cancer, even with current reimbursed screening tools, according to Dr. Judy Yee, a member of the American College of Radiology Colon Cancer Committee.

Studies such as that publised in JAGS, however, confirm the notion that people of color have even lower screening rates than the general public, said Yee, who is also vice chair of radiology at the University of California, San Francisco.

"Having a tool available that would make colon cancer screening more appealing to the underscreened groups is important," she said.

It is always a good idea for people who realize this decision affects the U.S. public negatively to speak out, Yee said. Although the public comment period ended on March 13, people can still write to their representatives in Congress. CMS is expected to release a final decision on CTC screening coverage in May.

"A lot of effort has been put into the science behind CTC," she said. "I would hope that CMS recognizes that every day that we don't have national coverage for CTC, we really are doing a disservice to the American public."

For more information from the Diagnostic Imaging and SearchMedica archives:

CMS' rejection of screening colonography payment vexes radiologistsCMS denies reimbursement for CT colonography screeningMultifaceted effort propels CT colonography forwardCTC can diagnose more than cancer