Obese people on Medicare  now have the opportunity to have regular weight loss counseling paid for when offered by a primary care provider.  Since this is considered prevention, there is no co-pay.

On November 29, the Centers for Medicare and Medicaid Services announced that there was enough evidence that intensive behavioral counseling was reasonable and necessary to prevent disease or disability and that Medicare beneficiaries were entitled to coverage as a preventive service.

This is particularly good news for people trying to prevent colon or rectal cancer since studies have consistently found a link between body mass index (fatness) and colorectal cancer, including the World  Cancer Research Foundation which included BMI and colorectal cancer in their 2007 comprehensive analysis reported in  Food, Nutrition, Physical Activity and the Prevention of Cancer. Read the rest of this entry »

American Cancer Society Chief Medical Officer Otis W. Brawley, M.D., says that he is disappointed in the decision by the Centers of Medicare and Medicaid Services not to cover CT colonography screening for elderly Americans on Medicare.

Dr. Brawley points out that randomized clinical trials have shown the CTC option as effective as traditional optical colonoscopy in finding early cancers and precancerous polyps.  He also concerned that there is not a sufficient supply of trained specialists providing colonoscopy to meet the need for screening and that new options are needed.

The American Cancer Society believes, Brawley says, that a full battery of testing for colorectal cancer screening should be available, particularly to the Medicare population who are at higher risk of developing and dying from colorectal cancer. Read the rest of this entry »

The Centers for Medicare and Medicaid issued a final National Coverage Decision on May 12, 2009 denying Medicare payments for CT colonography (virtual colonoscopy) to screen for colorectal cancer.

Despite an overwhelming number of comments urging that CMS overturn their provisional determination not to cover the test, the agency remained unconvinced that there was sufficient evidence to conclude that CT colonography was appropriate to screen for colorectal cancer.

Almost 95 percent of 357 comments supported CT colonography screening, including comments from the American Cancer Society and C3:Colorectal Cancer Coalition.

Briefly,

The Centers for Medicare and Medicaid Services (CMS) concludes the following:

The evidence is inadequate to conclude that CT colonography is an appropriate colorectal cancer screening test under § 1861(pp)(1) of the Social Security Act.  CT colonography for colorectal cancer screening remains noncovered.

In response to a proposed national coverage decision by the Centers for Medicare and Medicaid Services not to pay for screening CT colonography (CTC) for Medicare enrollees, C3 has submitted comments asking that CMS cover screening CT colonography (virtual colonoscopy) as part of a Coverage with Evidence Development (CED) process.

A CED would enable CMS to determine if CT colonography is safe and effective in the older Medicare population and which patients might benefit from screening using CTC rather than optical colonoscopy.

We believe that older patients should have a choice for colorectal cancer screening methods after a discussion of the risks and benefits of each method with their doctors.  And we want good information available for those patient decisions.  Read the rest of this entry »

On February 11, 2009 the Centers for Medicare and Medicaid Services (CMS) issued a proposed national coverage decision memorandum not to pay for computed tomographic colonography (so-called virtual colonoscopy) to screen for colorectal cancer.

The evidence is inadequate to conclude that CT colonography is an appropriate colorectal cancer screening test under §1861(pp)(1) of the Social Security Act. CT colonography for colorectal cancer screening remains noncovered.

The national coverage decision will not be final until 30 days after February 11 to allow for public comments.  Individuals and organizations concerned about the proposed decision can submit a comment online. However, CMS does not now cover screening CT colonography.

IMPORTANT: If you want to submit a comment to CMS online, you MUST click on and open the CMS PHI Posting Policy and then check off that you have read it.  If you don’t click on the underlined link, you cannot enter a check mark, your personal information, or your comment. Read the rest of this entry »