Comment:


By accident or on purpose the goal is to avoid spending money.
regardless of the medical benefit to the individual involved. The side
benefit is that the die off percentage is kept at a specific rate by
denying medical care to those who are beyond a specific age it helps
social security to stay solvent.

While it may appear to be ghoulish opinion, it is in
fact the truth. Why else would they withhold medical care based on an
individual’s age, or their access to medical care because 1. They are too
old 2. or the cost is considered.......... tells me it is all about the
benjamins, not about the people that Medicare is supposed to help.



http://www.medscape.com/viewarticle/824427?nlid=56003_2741&src=wnl_edit_dail
Panel Says No to Medicare Coverage for Lung Cancer Screening

Zosia Chustecka

May 01, 2014

After a day's deliberation, an advisory panel voted last night against
recommending national Medicare coverage for annual screening for lung
cancer with low-dose computed tomography (CT) in high-risk individuals.

The Medicare Evidence & Coverage Advisory Committee (MEDAC), composed
mostly of clinicians, was asked to vote on a scale of 1 to 5 on whether
they were confident that the benefits of such screening outweigh the harms
in the Medicare population (persons older than 65 years). The mean score of
the vote was 2, which shows low to intermediate confidence, according to
press reports of the meeting.

Evidence considered by the panel included results from the National Lung
Screening Trial, which show that CT screening significantly reduces lung
cancer deaths (by 20% compared with chest x- rays). The results have been
hailed as a great step forward for lung cancer and have led to many medical
societies recommending screening, including the National Comprehensive
Cancer Network <http://www.medscape.com/viewarticle/753757> (NCCN) and
the American
Cancer Society <http://www.medscape.com/viewarticle/777636>, among others.
Last year, the United States Preventive Services
Force<http://www.medscape.com/viewarticle/818485>(USPSTF) issued a
grade B recommendation for annual CT screening for lung
cancer.

Under the Affordable Care Act (ACA), any procedure that receives a grade B
recommendation from the USPSTF has to be covered by private insurers
without a copay. However, the ACA does not specify that Medicare has to do
so.

But the Medicare population is exactly the population that could benefit
from lung cancer screening, which is recommended for indivuduals aged 55 to
80 years who have a history of smoking (30 pack/year) and who are currently
smoking or who quit within the last 15 years.

The Centers for Medicare & Medicaid Services (CMS) received and accepted 2
formal requests <http://www.medscape.com/viewarticle/820546> to initiate
national Medicare coverage for lung cancer screening, which was followed by
an open comment period. The formal requests came from Peter Bach, MD,
director of the Center for Health Policy and Outcomes at the Memorial
Sloan-Kettering Cancer Center in New York City, and Laurie Fenton Ambrose,
president and CEO of the Lung Cancer Alliance.

In addition, a collection of more than 40 medical societies, including the
Lung Cancer Alliance, the Society of Thoracic Surgeons, and the American
College of Radiology (ACR), has petitioned <http://tinyurl.com/pwn4nad> the
CMS to provide national Medicare coverage of lung cancer screening.

The latest development, yesterday's decision by the MEDAC panel to vote
against recommending Medicare coverage for lung cancer screening, has come
as a bit of a surprise and has already been condemned by the ACR, which
warns that "lives may be lost" as a result.

However, the MEDAC panel recommendation is not binding.

The CMS is expected to issue a proposed decision on the issue by November
2014, and a final decision in February 2015.

Refusing Medicare coverage for lung cancer screening "penalizes many
seniors and may result in lives lost," the ACR warns in a
statement<http://tinyurl.com/qfyb6v8>
.

"Without national Medicare coverage for CT lung cancer screening, seniors
face a 2-tier coverage system in which those with private insurance will be
covered for these exams and many of their lives saved, while Medicare
beneficiaries are left with lesser access to these exams and placed at
increased risk of dying from lung cancer," commented Ella Kazerooni, MD,
chair of the ACR Lung Cancer Screening Committee.

"We strongly urge CMS to act on the evidence and the USPSTF recommendations
and provide full national coverage of CT lung cancer screening for high
risk patients," the ACR said in a statement.





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