CMS Addresses Appropriateness of Paying for Certain RadOnc Prostate Treatments

Apr 21, 2010 01:34 PM
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Baltimore is hosting the Medicare Evidence Development & Coverage Advisory Committee meeting this week to determine whether coverage of certain radiation oncology treatments for prostate cancer is appropriate.  As prostate cancers are so slow-growing that most patients die of other causes, does it make sense for a patient to undergo risks and costs of surgery, invasive or non-invasive?

The RadOnc treatments being discussed include CyberKnife, external beam radiation and the implantable radiation seeds.  Currently, Medicare coverage of these treatments is determined on a region-by-region basis, with the Northwest not covering them at all and only certain areas of the West Region will pay for them.

The panel assembled to debate such treatments’ value include outside experts who will try to come to some consensus.  The final ruling by CMS is not expected for at least six months, but whatever they decide to do will most likely affect decisions by private insurance carriers.

Stay tuned for more details.  For more information on this meeting, go to this page from Reuters.

Radiation Oncology

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