Medicare Denies Coverage for 'Virtual Colonoscopy'

Advocacy, professional groups say decision will prevent widespread screening that could save lives
By Jeff Muise
HealthDay Reporter

THURSDAY, May 14 (HealthDay News) -- The Centers for Medicare and Medicaid Services (CMS) announced May 12 that it would not cover the cost of so-called "virtual colonoscopies," colon screenings using computed tomography scanning devices. The decision was immediately blasted by the American Cancer Society (ACS) and the American College of Radiology (ACR).

In its decision, CMS called the virtual colonoscopies a "promising technology," but said "the evidence is not sufficient to conclude that screening computed tomography colonography (CTC) improves health benefits for asymptomatic, average risk Medicare beneficiaries."

Otis W. Brawley, M.D., the chief medical officer at ACS, said randomized clinical trials have shown CTC to be as effective as colonoscopy for the early detection of cancers and premalignant lesions. Brawley said CTC would permit widespread screening not now possible as there are a limited number of gastroenterologists to perform colonoscopies. An ACR spokesman said the CMS decision would effectively deny screening to many people, especially minority populations.

"Make no mistake: If let stand, this CMS decision not to pay for CTC 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 H. Thrall, M.D., chair of the ACR Board of Chancellors, who urged Congress to overrule CMS and vote to mandate coverage of CTC.

CMS Coverage Decision
American Cancer Society Statement
American College of Radiology Statement

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