Medicare won't cover computed tomography (CT) colonography screenings for colorectal cancer (CRC), CMS said in a decision memo on May 12.
The agency stated: "The evidence is inadequate to conclude that CT colonography is an appropriate colorectal cancer screening test under §1861(pp)(1) of the Social Security Act. CT colonography for colorectal cancer screening remains noncovered."
CMS added that the new technology is promising, but "many questions on the use of CT colonography need to be answered with well designed clinical studies that focus on health outcomes for the Medicare population. Until the evidence is sufficient, CMS strongly encourages physicians and beneficiaries to participate in CRC screening by selecting one of the several CRC screening tests that are currently covered under Medicare (Section 210.3 - Colorectal Cancer Screening Tests)."
The American College of Radiology (ACR) disagreed with CMS's decision. In a statement, the college asked CMS to reverse the decision and allow the noninvasive test.
"Make no mistake: If let stand, this CMS decision not to pay for CT colonography will cost lives. More than 140,000 Americans are diagnosed with colorectal cancer each year. Nearly 50,000 of them die due to late detection. How can CMS ignore the fact that people are dying because they do not want to have the tests that are currently covered?" said James Thrall MD, chair of ACR's Board of Chancellors. "For CMS to turn its back to a technology that can attract more patents to be screened and save countless lives is deeply concerning. CMS should reverse this determination immediately or Congress should step in and vote to mandate coverage of CTC."