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February 15, 2022

Around the nation: CMS announces expanded coverage for lung cancer screening

Daily Briefing

    CMS expanded coverage for low-dose computed tomography lung cancer screening to Medicare beneficiaries 50 and older, in today's bite-sized hospital and health industry news from Arkansas and Maryland.

    • Arkansas: Walmart on Friday announced that fully vaccinated employees in Walmart and Sam's Club stores will no longer be required to wear face masks on the job, unless they are required under state or local mandates. However, the company will still require all unvaccinated employees to wear masks until further notice. In addition, masks will still be required for employees working in "clinical care settings," including pharmacies, regardless of vaccination status. Ultimately, Walmart said that while most vaccinated workers are no longer required to wear a mask, "[it] support[s] and respect[s] an individual's choice to continue wearing one." (Firozi, Washington Post, 2/13)
    • Maryland: CMS on Thursday expanded coverage for lung cancer screening with low-dose computed tomography (LDCT) to Medicare beneficiaries 50 and older. In addition, Medicare will now cover the screening for individuals with a smoking history of 20 packs of cigarettes per year—a decrease from the previous requirement of 30 packs per year. Medicare's expanded LDCT coverage aligns with current recommendations, such as those from the U.S. Preventative Services Task Force (USPSTF), and more closely mirrors LDCT coverage offered by private insurers. For example, Ethan Slavin, a spokesperson for Aetna, said that the company considers annual LDCT screening "medically necessary for current or former smokers ages 50 to 80 years with a 20 pack-year or more smoking history and, if a former smoker, has quit within the past 15 years." Similarly, UnitedHealthcare commercial has also "implemented [coverage] consistent with USPSTF guidance," according to spokesperson Heather Soule. (Schroeder, MedCity News, 2/13) (The Daily Briefing is published by Advisory Board Research, a division of Optum, which is a wholly owned subsidiary of UnitedHealth Group. UnitedHealth Group separately owns UnitedHealthcare)
    • Maryland: CMS on Friday announced that it would delay the release of its updated Overall Hospital Quality Star Ratings list on the Care Compare website from April to July to correct a calculation error in the 2021 results for the OP-10 outpatient imaging efficiency measure. "As a result of this issue and a commitment to data accuracy, CMS will update the 2021 OP-10 measure results as well as the Overall Hospital Quality Star Ratings on Care Compare in July 2022 to correct the error and reflect the accurate results," CMS said. According to the announcement, the agency will not require any additional data or actions from hospitals for the recalculation. Although the list will not be officially released until July, hospitals will be able to preview the updated overall star ratings as well as the OP-10 measure results this spring. "To minimize stakeholder confusion, CMS is also delaying the public reporting of [calendar year] CY 2022 OP-10 measure results," the agency said. "These measure results are for CY 2023 payment determination, and were initially scheduled for preview release in Spring 2022. CMS intends for the calculation error to be corrected in this and in future reporting of results for the OP-10 measure." (AHA News, 2/11)

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