April 08, 2021

ACR Urges Top National Insurers to Update Lung Cancer Screening Coverage

The American College of Radiology® (ACR®) collaborated with the GO2 Foundation for Lung Cancer and the Society of Thoracic Surgeons to send a letter to the top five national private insurers (Aetna, Anthem, Cigna, Health Care Services Corporation, and UnitedHealthcare) requesting that the payers update their lung cancer screening (LCS) coverage policies in accordance with the updated United States Preventive Services Task Force (USPSTF) guidelines as soon as possible.

The April 1 letter urged the insurers to update their LCS coverage policies to reflect the USPSTF grade B recommendation that 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 age 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 update their LDCT lung cancer screening coverage policies immediately to save the largest number of lives possible.

Questions about private insurer coverage of LCS should be directed to Katie Keysor, ACR Senior Director of Economic Policy.