The American College of Radiology® (ACR®) has developed a form letter for lung cancer screening centers to send to their state and local private insurers urging them to update their lung cancer screening (LCS) coverage policies in accordance with the recently updated United States Preventive Services Task Force (USPSTF) LCS guidelines (download the form letter). The USPSTF grade B recommendation expands annual lung cancer screening with low-dose CT by lowering the start age to 50, and smoking pack-year eligibility criteria from 30 pack-year to 20-pack year. The previous recommendation included individuals ages 55 to 80 with a 30 pack-year smoking history.
The Patient Protection and Affordable Care Act of 2010 requires insurers to cover preventive services with an “A” or “B” rating by the USPSTF at no cost to patients. However, payers are given up to one year from the start of the next plan year to update their coverage policies when USPSTF guidelines are changed. Given the impact the updated USPSTF recommendations could have on the population’s lung cancer diagnosis and death rate prevalence, the joint letter requests that the insurers immediately update their low-dose computed tomography lung cancer screening coverage policies to save the largest number of lives possible.
The ACR collaborated with the GO2 Foundation for Lung Cancer and the Society of Thoracic Surgeons in early April to send a similar letter to the top five national private insurers (Aetna, Anthem, Cigna, Health Care Services Corporation, and UnitedHealthcare).
Questions about private insurer coverage of LCS should be directed to Katie Keysor, ACR Senior Director of Economic Policy.