Novel Multi-Cancer Screening Granted for Medicare Patients, Closing the Inequality Gap for Underserved Communities

The United States House of Representatives introduced the Multi-Cancer Early Detection Screening Coverage Act, which would give Medicare beneficiaries access to innovative multi-cancer screening technology by guaranteeing timely Medicare coverage of these tests.

On December 3, members of the United States House of Representatives introduced the Multi-Cancer Early Detection Screening Coverage Act (H.R. 8845), which would give Medicare beneficiaries access to innovative multi-cancer screening technology by guaranteeing timely Medicare coverage of these tests.1

“Cancer survival rates are higher when detected early, but we are losing too many Americans to cancer simply because we do not catch it early enough. Too often, those who are most likely to be diagnosed at late stages are members of our most vulnerable communities: minority, economically fragile, and rural populations,” Representative Terri Sewell, the lead sponsor of the bill, said in a statement. “Our transformative legislation will help ensure Medicare beneficiaries are able to benefit from breakthrough screening technologies. I look forward to working with my colleagues to modernize the Medicare coverage statute and ensure timely access to multi-cancer screening for beneficiaries.”

This legislation is aimed to correct misalignment between the latest advances in the cancer screenings and the Medicare coverage. To do so, the bill will create the authority for the Centers for Medicare and Medicaid Services (CMS) to cover blood-based tests for early detection of multiple types of cancer prior to patients experiencing symptoms.

It will also cover future test methods, such as urine or hair tests, once they are approved by the FDA. CMS will continue to have the authority to use an evidence-based process to determine the coverage parameters for these new tests. All of these new screening tools will be in addition to the existing screenings and coverage, not replacing them, and cost sharing will not be affected.

“This year has exposed the inequities in our nation’s healthcare system, but we have known for some time that cancer has an outsized impact on communities of color,”Gary A. Puckerin, PhD, president and chief executive office of National Minority Quality Forum, said in a press release. “We must be ready to take full advantage of new technologies that give us the chance to not only close the gap in cancer outcomes among racial and ethnic groups but also reduce patient risk for everyone. New multi-cancer early detection tests hold that promise and this legislation is essential to helping us achieve it.”

Organizations such as the Association of Community Cancer Centers (ACCC) will utilize the Multi-Cancer Early Detection Screening Coverage Act to reach out to underserved or rural communities. In their statement, ACCC discusses how this new policy will allow providers the chance to make significant progress in lowering cancer mortality rates; and that this coverage is critical to uptake, utilization, and maximizing efficiency and effectiveness of early detection.2

"As a community health center serving on the front lines in a region that's predominantly people of color, we see first-hand the inequities that exist related to cancer diagnosis, treatment, and outcomes," Anthony Gardner, CEO of Alabama Regional Medical Services, said in a statement.1 "We know that late-stage cancer is extraordinarily deadly. This legislation will place another tool in our arsenal to detect cancer early when it is easiest to treat and survival is greatest."

Currently, coverage from Medicare for preventive services is limited to circumstances were Congress had explicitly authorized coverage or the United States Preventive Services Task Force recommends the service as grade A or B. Without this legislation, many years could pass after an FDA approval before Medicare beneficiaries could receive coverage for preventive tests. This bill would reduce these delays for seniors while allowing CMS to determine coverage using its evidence-based process.

“I see firsthand that the health of rural residents suffers because of where we live,”Keshee Dozier-Smith, chief executive officer of the Rural Health Medical Program, said in a press release. “The communities that we serve are underinsured and uninsured minorities that suffer from chronic health conditions, with cancer being one of the leading deaths that go undetected in rural communities in Alabama due to the lack of availability and affordability. Providing access to Multi-cancer Early Detection Screenings creates opportunities to make real progress in the individuals and families we serve sooner rather than later in closing this gap.”

References:

1. Reps. Sewell, Arrington, Ruiz, and Hudson Introduce Bipartisan Legislation to Remove Barriers to Innovative Multi-Cancer Screening Technology for Medicare Beneficiaries. News release. Sewell. December 3, 2020. Accessed December 18, 2020. https://bit.ly/2LLNjKJ

2. Association of Community Cancer Centers (ACCC) Statement on H.R. 8845, the Multi-Cancer Early Detection Screening Coverage Act. News release. ACCC. December 9, 2020. Accessed December 18, 2020. https://bit.ly/3h57Q8D