Weekly Column: Ensuring Idaho Medicare Recipients Receive Coverage for Cancer Detection


July 26, 2021

Guest column submitted by US Senator Mike Crapo

Under current law, Medicare only covers preventative services that Congress has explicitly authorized or that the United States Task Force on Preventive Services has recommended. As a Republican-ranked member of the Senate Finance Committee that oversees a wide range of federal policies, including social service and health care programs, I reintroduced S. 1873, the 2021 law on coverage of early detection of multi-cancer cancer. This legislation would ensure Medicare beneficiaries in Idaho and across America have coverage for innovative tests that can detect multiple types of cancer before symptoms develop. This bipartisan legislation will help protect both patients and taxpayers by providing Medicare coverage for screening tests to save lives and costs to the health care system.

More than 300 leading healthcare organizations in the United States support the Medicare Multi-Cancer Early Detection Screening Coverage Act. These groups include the Idaho Academy of Family Physicians; Idaho Medical Association; Idaho Seniors Life Council; Idaho Clinical Oncology Society; and Idaho Technology Council. In a letter of support, these groups raised the issue: “Today, routine screening is only reimbursed for five types of cancer: breast, cervical, colorectal, cancer. prostate and lung (only in people at high risk of lung cancer). This leaves the vast majority of cancers without screening tests available and these cases account for nearly three in four cancer deaths in the United States each year. . . . Currently, Americans most at risk for cancer (Medicare beneficiaries) will face significant barriers to coverage of multi-cancer early detection tests, even when approved. [U.S. Food and Drug Administration] FDA. “

Without this legislation, it could take several years after FDA approval for Medicare to cover new cancer early detection technologies. To ensure timely and consistent coverage of screening items and services, Medicare’s Early Screening Cancer Early Detection Coverage Act would establish a defined benefit category and reduce such delays, deferring health care decisions to the public. providers and patients.

“The Idaho Medical Association applauds the leadership of Senator Mike Crapo on this important legislation. In my practice, early detection and diagnosis is critical to patient health and outcomes. By allowing Medicare to cover multi-cancer screens, patients and physicians will have increased access to the innovative tools needed to improve cancer control outcomes. “-Dr. Joseph Williams, President of the Idaho Medical Association

Congress has previously acted to ensure Medicare coverage for other cancer screenings, including mammography and colorectal screenings. Medicare Multi-Cancer Early Detection Screening Coverage:

  • Create an authority for the Centers for Medicare and Medicaid Services (CMS) to cover the latest diagnostic technologies, once approved by the FDA, including blood-based multi-cancer early detection tests and future testing methods using urine or hair samples;
  • Maintain the authority of the CMS to use an evidence-based process to determine coverage parameters for these new tests;
  • Declare that new diagnostic technologies will complement, not replace, existing screenings and will not impact existing coverage and cost sharing; and
  • Request the Government Accountability Office to issue a report that tracks usage and makes recommendations for expanding usage.

Senator Michael Bennet (D-Colorado), a member of the Senate Finance Committee, joined me in reintroducing this legislation which is also co-sponsored by Senators Tim Scott (R-South Carolina), Ben Cardin (D -Maryland), Tom Carper (D-Delaware) and John Barrasso (R-Wyoming).

Medicare should enable patients to access healthcare innovations as they become available. I look forward to the enactment of this important legislation that will help ensure that federal health care policy keeps pace with advances in medicine so that Idahoans and all Americans have access to life-saving medical care as soon as possible.

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