CTC advocates urge CMS to scrap decision

Advocates of virtual colonoscopy (also known as CT colonography or CTC) are urging the U.S. Centers for Medicare and Medicaid Services (CMS) to overturn a May 12 decision to deny CTC coverage for Medicare recipients.

In a statement released today, the CTC Working Group, a lobbying group of physician providers, patient advocates, and imaging equipment manufacturers, said it was disappointed that the rule remained unchanged and called on CMS to immediately reopen the rulemaking process to consider new clinical data.

"We were hopeful CMS would allow seniors access to virtual colonoscopies, which can aid in the early detection and prevention of colon cancer and save lives," said Andrew Spiegel, CEO of the Colon Cancer Alliance, a member of the CTC Working Group. "While we believe ample data currently exists to support a positive decision today for Medicare reimbursement of virtual colonoscopy, CMS should immediately reopen the review process to account for any new data and evidence that emerges showing efficacy of CTC in the Medicare population."

A letter to CMS from Rep. Kay Granger (R-TX), Rep. Patrick Kennedy (D-RI), and 40 congressional colleagues stated that CMS is missing a "landmark opportunity to positively impact colorectal cancer screening rates." The letter cites data from the National Naval Medical Center in Bethesda, MD, showing a 70% increase in colorectal cancer screening rates since it added VC as an option for patients.

In an e-mail to AuntMinnie.com, Dr. Otis Brawley, chief medical officer at the American Cancer Society (ACS), said he was disappointed in the decision because the evidence clearly shows that VC "is as effective as optical colonoscopy for the early detection of early cancers and premalignant lesions."

Medicare coverage for CTC would have provided a critical new option for colorectal cancer screening, Brawley added.

"Additional options are absolutely necessary as the supply of gastroenterologists is currently inadequate to supply optical colonoscopy to all of those who need it," he wrote. "It is our belief that by increasing the proportion of Americans 50 and over who get colorectal cancer screening, we could increase the number of lives saved from this devastating disease and decrease long-term medical costs."

Related Reading

CMS rejects Medicare coverage for virtual colonoscopy, May 12, 2009

Pressure builds on CMS to pay for VC, April 2, 2009

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

MedCAC panel members question VC's effectiveness, November 25, 2008

American Cancer Society recognizes virtual colonoscopy screening benefit, March 5, 2008

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