More Than 40 Lawmakers Sign Letter Asking CMS To Reverse Decision On Medicare Coverage For Virtual Colonoscopies

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Colorectal Cancer
Article Date: 18 Mar 2009 - 4:00 PDT

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More than 40 members of Congress have signed a letter asking CMS to reverse its tentative decision to end Medicare coverage for virtual colonoscopies, or CT colonographies, CQ HealthBeat reports. CMS announced the decision on Feb. 11 based on a lack of evidence that virtual colonoscopies result in improved health for Medicare beneficiaries who do not have symptoms of and have average risk for colon cancer. CMS requested public comments on the decision.

The letter -- dated March 13 and signed by Reps. Kay Granger (R-Texas) and Patrick Kennedy (D-R.I.), among other lawmakers -- maintains that Medicare coverage for virtual colonoscopies could increase screening rates for colon cancer. According to the letter, screening rates for colon cancer increased by 70% at National Naval Medical Center after the center added virtual colonoscopies as an option for patients. Medicare coverage of virtual colonoscopies as a "minimally invasive screening test for colon cancer would not just encourage more patients to undergo screening, but it would potentially close or eliminate the gap in colorectal cancer screening between whites and minority populations," according to the letter.

CMS spokesperson Don McLeod said that the agency takes "all such letters very seriously" and plans to "respond to the members promptly" (Kim, CQ HealthBeat, 3/16).

Letter to the Editor
A Feb. 28 New York Times editorial praised the tentative decision by CMS, but agency officials should "reconsider their initial coverage denial for a screening tool that could contribute to saving both lives and health care dollars," Andrew Spiegel, CEO of the Colon Cancer Alliance; Ilyse Schuman, managing director of the Medical Imaging and Technology Alliance; and James Thrall, chair of the American College of Radiology Board of Chancellors, write in a Times letter to the editor. According to the authors, a clinical trial conducted in 2007 by the American College of Radiology Imaging Network involving more than 2,600 patients "demonstrated the clinical efficacy" of virtual colonoscopies and the "potential to enhance colon cancer screening compliance," and "it's been shown that virtual colonoscopy is less than half the cost of the optical test."

They add, "With less than half of all Americans 50 and older receiving colon cancer screening, Medicare's decision to deny the elderly access to virtual colonoscopy would maintain needless screening barriers that research proves disproportionately affect nonwhite and low-income Americans" (Spiegel et al., New York Times, 3/14).

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