January 12, 2021
Kansas Medicaid beneficiaries who are at high risk for lung cancer may qualify to receive lung cancer screenings at no cost. KanCare is the program through which the state administers Medicaid.
Medicaid beneficiaries are disproportionately affected by lung cancer, yet standard Medicaid programs are one of the only healthcare payers not required to cover lung cancer screening. In 2020, the Kansas Department of Health & Environment (KDHE) added coverage for low-dose CT scans to screen for lung cancer. Previously, KanCare was one of about 12 Medicaid fee-for-service programs that did not cover lung cancer screening.
According to the American Lung Association, only 16 percent of lung cancer cases are diagnosed early when the disease is most treatable. Low-dose computed tomography (LDCT) screening among those at high risk for lung cancer can help detect lung cancer earlier and has been shown to reduce the death rate by up to 20 percent.
Members of The University of Kansas Cancer Center played an integral role educating policymakers about the importance of lung cancer screening coverage, partnering with local advocates from the National Alliance on Mental Illness (NAMI), the American Lung Association and the American Cancer Society Cancer Action Network. Kimber Richter, PhD, MPH, director of the University of Kansas Health System's UKanQuit tobacco cessation program, was one of many who helped bring the coverage issue to the attention of the KDHE.
“This is a terrific example of what can happen when treatment providers, patient advocates, policy experts and insurers work together to bridge health inequities and meet the healthcare needs of Kansans,” Dr. Richter said.
Nirmal Veeramachaneni, MD, thoracic surgeon, serves on a State-Based Initiatives task group to reduce the incidence of mortality from lung cancer. This initiative was formed by the National Lung Cancer Roundtable (NLCRT). According to Dr. Veeramachaneni, while this coverage is a big step forward improving the health of Kansans, coverage gaps persist.
“It is no surprise that the financially poor have reduced access to healthcare and tend to have worse outcomes even after cancer diagnosis,” Dr. Veeramachaneni said. “We still face significant gaps in cancer care for this vulnerable group of patients. For example, positron emission tomography (PET) scans, which can help stage a cancer, are still not covered.”