Pressure builds on CMS to pay for VC

Members of Congress and lobbyists are putting pressure on the U.S Centers for Medicare and Medicaid Services (CMS) to reverse its opposition to federal reimbursement for virtual colonoscopy (also known as CT colonography, or CTC) screening.

In February CMS proposed a national coverage decision to deny reimbursement for screening CTC, citing insufficient evidence for its adoption. The agency is expected to announce a final decision on May 19.

In response to CMS' opposition to coverage, and in observation the 10th anniversary of Colorectal Cancer Awareness Month, this week the U.S. House of Representatives passed Congressional Resolution 60, sponsored by Rep. Kay Granger (R-TX). The resolution calls for increased support for colorectal cancer screening for Americans age 50 and older.

A statement from the CTC coalition, which includes the Colon Cancer Alliance, the American College of Radiology, and the Medical Imaging and Technology Alliance (MITA), stated that Medicare coverage for VC screening would break down barriers to screening for the populations most at risk of the disease.

In a letter to CMS, Granger and U.S. Rep. Patrick Kennedy (D-RI), along with 40 colleagues, expressed their concerns with CMS' proposed coverage decision, according to the CTC coalition. The letter cited CTC as a less invasive screening procedure compared to colonoscopy, and one that promises to increase colorectal cancer screening rates.

In another letter to CMS cited by the CTC coalition, U.S. Rep. Danny Davis (D-IL) and 12 colleagues emphasized the importance that Medicare coverage of CTC for African Americans. Colorectal cancer is the third most common cancer among African Americans today, while deaths and incidence rates remain higher for African Americans than other ethnic groups, Davis' letter stated.

Related Reading

Half of states now offer private-payor VC coverage, April 2, 2009

VC/AAA screening combo cost-effective in older adults, March 26, 2009

Colonoscopy seen as reducing CRC mortality in Germany, March 23, 2009

ACR urges Congressional support for CT colonography, March 16, 2009

CMS rejects case for virtual colonoscopy reimbursement, February 12, 2009

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