National Coverage Analysis (NCA) View Public Comments

Screening Computed Tomography Colonography (CTC) for Colorectal Cancer

Public Comments

Commenter Comment Information
P, D Date: 03/13/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

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Glenn, William Date: 03/13/2009
Comment:

With no doubt there is overwhelming evidence that Virtual Colonoscopy (VC) works and has dramatically improved since 2001 when VC had already been proven equal to Optical Colonoscopy (OC) for >10mm polyps. The question now is will CMS now do the right thing and take a courageous stand to SAVE LIVES in large numbers or capitulate to upholding the status quo? When a qualified(>7mm) polyp is found/removed, a life is potentially saved. No one disputes that. If "effective" CRC screening

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Prost, Jamie Title: Global Marketing
Organization: GE Healthcare
Date: 03/13/2009
Comment:

March 13, 2009

Charlene Frizzera, Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
7500 Security Blvd, Room 314G
Baltimore, MD 21244-1850

Re: Proposed Decision Memo for Screening Computed Tomography Colongraphy (CTC) for Colorectal Cancer (CAG-00396N)

Dear Ms. Frizzera:

GE Healthcare appreciates the opportunity to comment on the Centers for Medicare & Medicaid

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McGlothlin, Anita Title: Health Policy Administrator
Organization: American College of Radiology
Date: 03/13/2009
Comment:

March 13, 2009

Marcel E. Salive, M.D., M.P.H.
Director, Division of Medical and Surgical
Services
Centers for Medicare and Medicaid Services
Coverage and Analysis Group
7500 Security Blvd
Mail Stop C1-09-06
Baltimore, MD 21244

Re: Proposed Decision Memo for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N)

Dear Dr. Salive:

The American College of Radiology (ACR), representing over 32,000 diagnostic

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Silfen, M.D., Eric Title: Sr. Vice President & Chief Medical Officer
Organization: Philips Healthcare
Date: 03/13/2009
Comment:

March 13, 2009

Charlene Frizzera, Acting Administrator
Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
7500 Security Boulevard, Room 314G
Baltimore, MD 21244-1850

Dear Ms. Frizzera:

On behalf of Philips Healthcare (Philips), I am delighted to have this opportunity to comment on the Proposed Decision Memo for Screening Computed Tomography Colonography (“CTC”) for Colorectal Cancer (“CRC”) (CAG-00396N) (Proposed Decision). Philips

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Gonzalez, Ariel Title: Director, Congressional Affairs
Organization: American College of Radiology on behalf of the CTC Coalition
Date: 03/13/2009
Comment:

March 13, 2009

Charlene Frizzera, Acting Administrator
Centers for Medicare and Medicaid Services
U.S. Department of Health and Human Services
7500 Security Boulevard, Room 314G
Baltimore, MD 21244-1850

Dear Ms. Frizzera:

We, the undersigned organizations, write to request that the Centers for Medicare and Medicaid Services (CMS) cover computed tomography colonography (CTC) under a national coverage determination. We fully support national Medicare coverage of CTC

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Shah, Mona Title: Senior Policy Analyst
Organization: American Cancer Society Cancer Action Network
Date: 03/13/2009
Comment:

March 13, 2009

Charlene Frizzera
Acting Administrator
Centers for Medicare & Medicaid Services
Department of Health and Human Services
Room 445-G, Hubert H. Humphrey Building
200 Independence Avenue, SW
Washington, DC 20201

RE: CAG-00396N; Medicare Program; Proposed Decision Memo for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer

Dear Ms. Frizzera,

The American Cancer Society (the Society) respectfully submits the following

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Hawk, Dr. Ernest Title: Vice President for Cancer Prevention
Organization: UT MD Anderson Cancer Center
Date: 03/13/2009
Comment:

The faculty of UT M.D. Anderson Cancer Center whose research and clinical expertise relate specifically to colorectal cancer screening and prevention, would like to register our strong opposition to the recent proposed decision by CMS to deny coverage for CT colonography (CTC) as an appropriate colorectal screening test under Section 1861(pp)(1) of the Social Security Act. We find the scientific data as summarized in the proposed decision memo to be clinically compelling and entirely

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Shi, Justin Title: Associate Professor
Organization: Temple University
Date: 03/13/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

DeMarco, Nicholas Date: 03/13/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to

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Gollub, Marc J. Title: Director of CT, Department of Radiology
Organization: Memorial Sloan Kettering Cancer Center
Date: 03/13/2009
Comment:

March 12, 2009

Steve E. Phurrough, MD, MPH
Center for Medicare & Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850

Re: Proposed Decision Memo for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N)

Dear Dr. Phurrough:

As representatives of the faculty of the Memorial Sloan-Kettering Cancer Center we wish to voice our strong opposition to CMS’ recent proposed decision to deny coverage for CT colonography

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Schuman, Ilyse Title: Vice President, NEMA/Managing Director, MITA
Date: 03/13/2009
Comment:

March 13, 2009

BY ELECTRONIC DELIVERY

Ms. Charlene Frizzera
Acting Administrator
Centers for Medicare & Medicaid Services
Department of Health & Human Services
Baltimore, MD 21244-8016

Re: Proposed Decision Memorandum for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N)

Dear Ms. Frizzera:

The Medical Imaging and Technology Alliance (MITA), a division of the

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Allaire, RN, CGRN, Jane Date: 03/12/2009
Comment:

VC for CRC screening

I am asking that you reconsider coverage for VC as an option for colorectal cancer screening.

VC has a place for screening for those patients who don't want to undergo an invasive test. It also provides a method to screen patients who are on anti-coagulant therapy as well as those who have several co-morbidities and would have to alter their plan of care to undergo a colonoscopy.

I was the study coordinator for the initial VC stucy

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Bocchino, Carmella Title: EVP, Clinical Affairs and Strategic Planning
Organization: America's Health Insurance Plans (AHIP)
Date: 03/12/2009
Comment:

March 13, 2009

Steve Phurrough, MD, MPA
Director, Coverage and Analysis Group
Centers for Medicare and Medicaid Services
Mail Stop C1-09-06
7500 Security Boulevard
Baltimore, Maryland 21244-1850

Dear Dr. Phurrough:

Thank you for the opportunity to comment on the Centers for Medicare and Medicaid Services' (CMS's) call for a national coverage analysis on Screening Computer Tomography Colonography (CTC) for Colorectal Cancer

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Cole, Peter Date: 03/12/2009
Comment:

Dear Medicare Official/Representative______:

I am writing to voice my strong disagreement with Medicare's recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American's age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

Why did Medicare not acknowledge that more than 50% of Americans have no

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Garrett, Kathleen T. Date: 03/12/2009
Comment:

Dear Medicare Official

I am writing to voice my strong disagreement with Medicare's recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American's age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

Why did Medicare not acknowledge that more than 50% of Americans have not, will not, or cannot

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Greenlee, Janet Date: 03/12/2009
Comment:

[PHI Redacted] I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). I fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There h

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Hess, MSN RN, Paula Title: Cancer Screening Nurse Navigator
Organization: Bayhealth Medical Center
Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to

More

Holland, Tina Date: 03/12/2009
Comment:

Dear Medicare Official/Dear Senator______/Dear Representative______:

I am writing to voice my strong disagreement with Medicare's recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American's age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

Why did Medicare not acknowledge that more than 50%

More

nakamura, karyl Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to

More

Rowley, Allan J. Title: CEO
Organization: Medicsight PLC
Date: 03/12/2009
Comment:

Mr. William Larson, MA
Centers for Medicare and Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850
USA

March 13, 2009

Re:  Comments on Proposed Denial of Coverage for Screening with Computed Tomographic
Colonography (CTC) for Colorectal Cancer (CAG-00396N)

Dear Mr. Larson,

On behalf of Medicsight, I would like to take this opportunity to give comment concerning the potential ruling

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Rucker, MD, Donald W. Title: Vice President and Chief Medical Officer
Organization: Siemens Healthcare USA
Date: 03/12/2009
Comment:

March 13, 2009

Via Electronic Mail

Ms. Charlene Frizzera
Acting Administrator
Centers for Medicare & Medicaid Services
Department of Health & Human Services
Baltimore, MD 21244-8016

RE: Administrative File CAG-00396N
Screening Computed Tomographic Colonography (CTC) for Colorectal Cancer

Dear Ms. Frizzera,

On behalf of Siemens Healthcare USA, I would like to comment on CMS’s

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Salzano, Janet Date: 03/12/2009
Comment:

I support Medicare coverage of Virtual Colonoscopy procedure.

Shih, MD MS, David Title: Senior Director, Medical Affairs
Organization: American College of Preventive Medicine
Date: 03/12/2009
Comment:

Thank you for giving the American College of Preventive Medicine the opportunity to comment on this National Coverage Decision. For this proposed National Coverage Decision, CMS refers to the recommendations of and evidence compiled by the USPSTF to reach its conclusions. ACPM strongly supports the work of the United States Preventive Services Task Force (USPSTF) because of the quality of its analysis and scientific rigor, and, as such, supports the proposed National Covera

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Stephens, Margaret Date: 03/12/2009
Comment:

Dear Medicare Official:

I am writing to voice my strong disagreement with Medicare's recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American's age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

Why did Medicare not acknowledge that more than 50% of Americans have not, will not, or cann

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Porter, Patricia Title: Asst. Professor of English, Adjunct
Organization: NVCC-WO
Date: 03/12/2009
Comment:

Do NOT deny reimbrusement for Virtual Colonoscopies (VCs) to doctors who prescribe these for persons at risk of colorecal cancer who also receive health care through CMS.

Screening RELUCTANT people early for colon and rectal cancer is important. The VC can catch the fearful with their fake bravado, who avoid other colorectal screening measures. [PHI Redacted]

March has been dubbed National Cancer Awareness Month in the US. Well, let’s give all

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Kwatny, Rochelle Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

Kwatny, Eugene Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

McGarry, Deb Date: 03/12/2009
Comment:

After being diagnosed with Stage IV colon cancer in July of 2008, [PHI Redacted] lost his courageous battle on February 19, 2009. We have been left devastate, sad, and empty.

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test

More

Rotolo, Melissa Title: Volunteer
Organization: Colon Cancer Alliance
Date: 03/12/2009
Comment:

[PHI Redacted] I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). I fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has

More

McKinney, Judith Title: CTC
Date: 03/12/2009
Comment:

the need for this is far greater than any reason to cut it from coverage, [PHI Redacted]
Judith McKinney

Kaufman, Lenore Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

Stillman, Bradley Title: Executive Director
Organization: American College of Gastroenterology
Date: 03/12/2009
Comment:

Having participated in the various aspects of this proceeding as well as the MedCAC meeting on this topic in November, 2008, the American College of Gastroenterology (ACG) is pleased to have the opportunity to provide these additional comments with respect to CMS’ national coverage analysis (NCA) of computed tomography colonography (CT colonography). The College supports the draft decision to deny coverage for CT colonography at this time. The College will not repeat all of the

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Spiegel, Andrew Title: Chief Executive Officer
Organization: Colon Cancer Alliance
Date: 03/12/2009
Comment:

I write as the CEO of the Colon Cancer Alliance, the nation''s largest patient advocacy organization dedicated to colorectal cancer. We speak on behalf of the 1.2 people who currently have CRC as well as our more than 50,000 active members.

The Colon cancer alliance supports medicare coverage of CTC for CRC and respectfully requests a reversal of its preliminary decision against coverage.

The recent CMS proposed denial of coverage for CT Colonography (CTC) is based upon a

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Brunst, Robert Title: Owner
Organization: Robert F. Brunst M.D., Ph.D., Inc.
Date: 03/12/2009
Comment:

It is with great conviction that I urge the committee to reconsider the initial decision to deny coverage for CT Colonography.

As a practicing primary care physician of nearly 30 years, it is my ethical duty to utilize the most appropriate clinical tools that will best serve the well-being of my patients. One of these tools is CTC.

It is no secret that Colorectal cancer screening saves lives, and Medicare coverage of CTC will result in the screening of patients who are

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Petrini, John L. Title: President
Organization: American Society for Gastrointestinal Endoscopy (ASGE)
Date: 03/12/2009
Comment:

March 13, 2009

Mr. William Larson
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244-1850

Re: Proposed decision memo for screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N)

Dear Mr. Larson:

The American Society for Gastrointestinal Endoscopy (ASGE) appreciates the opportunity to comment on the Proposed decision memo for screening Computed Tomography Colonography (CTC) for Colorectal Cancer

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Bruno, Steve Date: 03/12/2009
Comment:

Optical colonoscopy is not working. A recent study published in 2008 has shown that the procedure remains under utilized in Medicare recipients. 'Underuse of colorectal cancer screening in a cohort of medicare beneficiaries', Gregory S. Cooper, Tzuyung Doug Kou, Cancer, Volume 112, Issue 2, Date: 15 January 2008, Pages: 293-299

In another study published in 2008 as well, it was shown that optical colonoscopy can miss polyps. 'Effect of Institution-Wide Policy of Colonoscopy Withdrawal

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Sandler, MD, AGAF, Robert S. Title: President
Organization: American Gastroenterological Assoc/ AGA Institute
Date: 03/12/2009
Comment:

March 12, 2009

Centers for Medicare and Medicaid Services
Coverage and Analysis Group
Attn: Mr. William Larson
7500 Security Blvd
Mail Stop C-1-09-06
Baltimore, MD 21244

Re: Proposed Decision Memo for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N)
Dear Mr. Larson:

The American Gastroenterological Association (AGA) is dedicated to the mission of advancing the science and practice of gastroenterology. Founded in 1897,

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Hartinger, Chris Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

Coulter, Steve Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

Weiner, Brian Title: President
Organization: Marlboro Gastroenterology/Radiology PC
Date: 03/12/2009
Comment:

Dear Sirs:

As one of the few gastroenterologists in the US with an integrated capacity to perform virtual colonoscopy [CTC] in my medical practice, I am uniquely positioned to comment on Medicare coverage for this procedure. I am writing you as I believe your recent proposed decision [CAG-00396N], not to cover virtual colonoscopy as a benefit for Medicare beneficiaries is in error. I recommend that Medicare: 1. cover virtual colonoscopy as a benefit for their beneficiaries, on the basis

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usinowicz, tom Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

Nenninger, John Date: 03/12/2009
Comment:

[PHI Redacted] is a colon cancer survivor. She has sufferred one recurrence. All told, she has had four colon surgeries. As the CTC procudure is non- invasive, it is an important and on-going tool in insuring recurrences are detected early. The invasive colonoscopy poses risks of perforation and other damage to an already damaged colon.

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national

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Choi, J. Richard Title: Radiologist/Shareholder
Organization: Fairfax Radiological Consultants, PC
Date: 03/12/2009
Comment:

As a former principal investigator for the Department of Defense Army Navy CT Virtual Colonoscopy Trial (Pickhardt 2003) and director for the Center for Virtual Colonoscopy at the Walter Reed Army Medical Center, and current director of Virtual Colonoscopy for the Fairfax Radiological Consultants, I am surprised and disappointed with the Centers for Medicare and Medicaid Services (CMS) decision to not cover CT colonography for colorectal cancer screening despite overwhelming evidence that

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Rivera, Dionne Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

fales, kerri Date: 03/12/2009
Comment:

I am in support of the vc being covered. [PHI Redacted] has just recently been diagnosed with colon cancer. By the time he noticed symptoms, it was in stage 4. He starts his chemo monday, and has a very long fight ahead of him. I did not no much like many other people about colon cancer, and how it begins. From the moment I found out about [PHI Redacted] I have been consumed in finding out all I can. Before a tumor becomes cancer it starts off as tiny

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Popp, Kimberly Date: 03/12/2009
Comment:

Last week, [PHI Redacted] passed away from a rough 8 month battle with colorectal cancer. The fight that she put up to keep her life was one in which no individual or family should have to go through. Therefore, I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). A virtual colonoscapy should be available to everyone to curb the outcome

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DROZD, LOUIS Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

Velez-Griffen, Diana Date: 03/12/2009
Comment:

I respectfully request that the Center for Medicare and Medicaid Services (CMS) propose Medicare coverage under a national coverage determination for computed tomography colonography (CTC). We fully support national Medicare coverage of CTC as an acceptable minimally-invasive screening test and an additional valuable tool in our arsenal for detecting and preventing colorectal cancer.

March is National Colorectal Cancer Awareness Month. There has never been a better time to implement

More

Taylor, Gregory Date: 03/12/2009
Comment:

CTC is not only less expensive than colonoscopy, it is safer. Death rates from colonoscopy reach one in five thousand. It is equally effective at finding curable colon cancer.

Albright, Mark Date: 03/11/2009
Comment:

History is replete with examples of governments, politicians, philosophers and businessmen making colossal blunders while clinging to mistaken ideals even in the face of significant evidence to the contrary. Further, many scientists who were once leaders in their field are, when illuminated by the cold light of history, considered jesters for rejecting and even suppressing revolutionary or paradigm-shifting scientific breakthroughs to protect their own careers and further their own

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Bergthold, Ph.D., Linda Title: Consumer representative to MedCAC
Date: 03/11/2009
Comment:

Dear Mr. Larson:

I am writing as a consumer representative to the MedCAC and a panel member of the California Technology Assessment Forum, re. the Medicare NCA for Screening CTC for colorectal cancer. I was a member of the MedCAC panel that reviewed this issue in November 2008. (Although I had to decline attendance at the last minute, I did read the materials and filled out the decision form) Just this week I was the discussant for CTAF's review of CTC.

The CTAF panel

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Porambo, Albert Title: Chief, Diagnostic Radiology
Organization: Walter Reed Army Medical Center
Date: 03/11/2009
Comment:

Ladies and Gentlemen, Below you will find several well written reasons that CTC must be supported as a critical colorectal cancer screening tool. At Walter Reed Army Medical Center, where I am the Chief of Diagnostic Radiology, even the gastroenterologists support its use as it expands the population able to be screened, increases the yield of optical colonoscopy, and is a PREVENTIVE modality by identifying polyps before they become symptomatic and malignant. Thnak you for your attention

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Poullos, Peter Title: Body Imaging Fellow
Organization: Stanford University
Date: 03/11/2009
Comment:

To Whom It May Concern:

I am writing to ask Medicare to reconsider its proposal not to reimburse screening CT colonography (CTC). You discuss several reasons for this decision in your proposal. However, the scientific literature clearly supports the accuracy and cost effectiveness of CTC, and I would like to address a few of your key points.

1. RADIATION EXPOSURE

You express a concern about excess radiation exposure. You cite a 2005 study by Brenner (Brenner and Georgsson 2005)

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Aldige, Carolyn Date: 03/11/2009
Comment:

These comments replace previously submitted comments on Tuesday, March 10. They contain an addition to the original comments.

March 11, 2009

The Prevent Cancer Foundation is a national non-profit organization whose mission is educing mortality from cancer through prevention and early detection. The organization funds research, provides direct screening and early intervention programs to the public, and educates men and women across the country about prevention and screening

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Arite, Joe Title: Director of Policy
Organization: C3: Colorectal Cancer Coalition
Date: 03/11/2009
Comment:

C3: Colorectal Cancer Coalition Comments Regarding the Centers for Medicare and Medicaid Services National Coverage Analysis on Computed Tomography Colonography and the Proposed Decision Memo for Screening Computed Tomography Colonography for Colorectal Cancer (CAG-00396N)
March 9, 2009

These comments are submitted by C3: Colorectal Cancer Coalition (C3), a non-profit, nonpartisan advocacy organization committed to the fight against colon and rectal cancer. We appreciate the

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King, Bernard Title: Chair, Department of Radiology
Organization: Mayo Clinic
Date: 03/10/2009
Comment:

Date: March 6, 2009

To: CMS
From: Mayo Clinic
Re: Proposed Decision for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAD00396M)

Dear Center for Medicare and Medicaid Services (CMS):

We are writing to petition CMS to reconsider their decision relating to computed tomographic colonography (CTC) for colorectal cancer screening. It is in the public interest to provide screening reimbursement for the Medicare population under a coverage with

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Barnhart, Blair Title: Director
Organization: Public Sector Initiatives
Date: 03/10/2009
Comment:

Please see the letter we have prepared in response to the proposed decision memo. In accordance with your instructions, it was emailed to CAGinquiries@cms.hhs.gov

Chin, G Date: 03/10/2009
Comment:

I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

Why did Medicare not acknowledge that more than 50% of Americans have not, will not, or cannot receive traditional colonoscopy as a

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jenkins, joseph Date: 03/10/2009
Comment:

March 10, 2009

Mr. William Larson, MA
Centers for Medicare and Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850

Re: NCA for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG- 00396N); Comments on Proposed Denial of Coverage

Dear Mr. Larson:

With its proposal to deny coverage for virtual colonoscopy for screening colon cancer in seniors on February 11, 2009, the Center for Medicare and Medicaid Services (CMS) missed

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Pappas, Kimberly Title: X-ray Supervisor
Organization: Minnesota Department of Health
Date: 03/10/2009
Comment:

If an abnormality is found on virtual colonoscopy, a follow-up study (colonscopy) is then required to remove the defect. The issue with any colonoscopy is the prep. As patient get older, the preparation is harder on their systems. The radiation dose from a virtual colonscopy does not justify its use, despite its sensitivity.

Kreeger, Kevin Date: 03/10/2009
Comment:

I must respectfully disagree with the decision to not cover CTC. With the overwhelming evidence that CTC, when performed by properly trained physician, is an effective screening test [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200] and is MORE sensitive than other already covered screening tests [Imperiale, TF, et al. N Engl J Med2000;343:169-74], [Winawer SJ, et al. N Engl J Med

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peeters, steven Date: 03/10/2009
Comment:

I am writing to voice my strong disagreement with Medicares recent denial of coverage for Virtual Colonoscopy. [PHI Redacted] The virtual colonoscopy is much more appealing option and I suspect a better cost alternative. Cost and screening effectiveness should be the goal. we must approve new processes that improve the willingness of people to get screened and treated if necessary. Lets stop being influenced by lobbies and do the right thing.

Butler, MD, PhD, Robert Date: 03/10/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

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Levin, Susan Date: 03/10/2009
Comment:

How many more Americans must die just because the US is more concerned with looking further into issues of "cost-effectiveness"? In the analysis for "cost effectiveness" - I am curious - were the burial costs of 50,000+ lost lives a year (due to preventable colon cancer) being factored into the equation? How about the cost of prolonging the lives of those who are agonizingly and needlessly suffering? Know what the big problem is? We are pumping taxpayer dollars into treating cancer

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DeFoe, Janis Date: 03/09/2009
Comment:

Dear Medicare,

I am a registered nurse who works in the home health field. I have just been informed that you have denied coverage for the Virtual Colonoscopy screening. I am extremey disappointed and hope you will seriously re-consider. Colon cancer kills more people each year than AIDS or breast cancer combined. We have a [PHI Redacted] right now who is only 50 who is dying of this horrid cancer and she would have been caught sooner with this exam. I have taken

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LaChappelle, Robb Date: 03/09/2009
Comment:

Dear CMS,

Please reconsider your position regarding Virtual Colonoscopy for the following reasons:

  • Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]
  • Colorectal cancer screening saves lives
  • Coverage of Virtual Colonoscopy will

    More

Caspers, John Date: 03/09/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

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Schoenecker, Steven Title: Radiologist
Organization: Valley Radiology
Date: 03/09/2009
Comment:

As a radiologist that monitors and interprets these exams I have firsthand experience with CT colonography studies and believe they provide a necessary alternative to other screening tests including colonoscopy. I believe the test is currently sufficiently accurate for screening and no doubt will continue to improve. There is potential for cost savings as well as CT screening is less costly than colonoscopy and carries fewer complications. Many of our patients have been pleased to have CT

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Syring, John Date: 03/09/2009
Comment:

I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

Why did Medicare not acknowledge that more than 50% of Americans have not, will not, or cannot receive traditional colonoscopy as

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sullivan, james Date: 03/09/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries. An important component of President Obama''s Health initiative is increased utilization of effective screening exams to improve patient health and control cost. CTC is such an exam.

Utilization of CTC for Medicare beneficiaries

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VELDMAN, MARK Organization: St. Paul Radiology
Date: 03/08/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

More

Barkmeier, Jeffrey Date: 03/08/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

More

Wittenberg, Keith Date: 03/08/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

More

Cox, David Date: 03/08/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

More

Wold, Peter Title: Attending Radiologist
Organization: Saint Paul Radiology, P.A.
Date: 03/08/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

More

Baldwin, Matthew Title: M.D.
Organization: St.Paul Radiology, P.A.
Date: 03/08/2009
Comment:

I thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen over the last seven years. Medicare beneficiaries who have a

More

weinmann, Robert Title: M.D.
Organization: St. Paul Radiology
Date: 03/08/2009
Comment:

First I would like to thank the committee for performing the evidentiary review of screening computed tomography colonography (CTC) for colorectal cancer. I however respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in our metropolitan subspecialty radiology practice has steadily risen since its introduction. Medicare

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Tashjian, Joseph Title: President
Organization: Saint Paul Radiology
Date: 03/08/2009
Comment:

Dear Sirs:

We respectfully disagree with the conclusion that CT colonography is not clinically effective for Medicare beneficiaries.

Utilization of CTC for Medicare beneficiaries by gastroenterologists and colorectal surgeons in Saint Paul, MN has steadily risen over the last seven years. Medicare and non-Medicare beneficiaries who have a contraindication to colonoscopy or sedation or who have undergone incomplete screening or diagnostic colonoscopy are now referred exclusively for

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Short, Larri Title: Outside Counsel filing on behalf of client
Organization: National Patient Advocate Foundation
Date: 03/08/2009
Comment:

March 6, 2009

Dr. Steve E. Phurrough
Coverage & Analysis Group
Office of Clinical Standards and Quality
Centers for Medicare & Medicaid Services
7500 Security Blvd. 21244-1850

Re: Proposed Decision Memorandum for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N)

Dear Dr. Phurrough:

Since 1996, the National Patient Advocate Foundation ("NPAF") has represented patients battling cancer and other life-threatening diseases, in concert

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meyer, joan Date: 03/08/2009
Comment:

PLEASE continue to cover the costs incurred by individuals for the Virtual Colonoscopy screening for CRC. Millions of lives have been spared as a result of screening for colon rectal cancer and this is an excellent and effective tool that should continue to be covered under MEDICARE.

Blanco, Barbara Title: MD
Organization: Danbury Radiological Associates
Date: 03/08/2009
Comment:

I feel strongly that screening CT colonography should be covered. While it may not be the test of choice for all patients, it is very useful in many instances, for example when optical colonoscopy is not possible, or when the patient is not willing to undergo optical colonoscopy. Given the incidence of colon carcinoma and the high financial and emotional costs associated, I think in the long run, it will save money.
Thank You,
Barbara Blanco

Price, Paul Date: 03/07/2009
Comment:

I would like to ask that you reconsider the proposed cut in reimbursement for virtual colonoscopy. Virtual colonoscopy has ben proven to be an accurate and cost effective way to screen for colon cancer.

Friedman, Arnold Title: Chief, Body Imaging
Organization: University of Arizona School of Medicine
Date: 03/07/2009
Comment:

We disagree with the decision not to recommend CTC for Medicare reimbursement. We have been doing fairly large volume screening CTC at two remote rural locations where fecal occult blood testing is not practical for most patients and screening optical colonoscopy is not readily available. Our data (not as yet published) can address the committee’s radiation concern and the extracolonic findings concern, and supplement the literature as to efficacy. We would also like to comment on the

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DeBiase, John Date: 03/07/2009
Comment:

Dear Members of CMS:

Thank you for accepting my comments in reference to the upcoming decision regarding CTC screening reimbursement approval for Medicare partcipants.

I have been working over the past six years with several physicians, cancer prevention charities, and commercial organizations to see that CTC becomes a viable CRC screening alternative for the tens of millions of Americans who currently do not seek screening due to their objection to the alternatives.

It is

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russo, gregg Date: 03/06/2009
Comment:

As an industry professional, I have been intimately involved in the evolution of CTC. I have studied the results of many of the trials including the recently reported ACRIN findings. As a result, I am confident that this procedure will drive more patients into the clinical pathway for screening of colon cancer. [PHI Redacted] I am extremely disappointed at this denial of reimbursement.

ALBERT, ANDRIANNA Title: Community Health Representative
Organization: Nimiipuu Health
Date: 03/06/2009
Comment:

I would like to see MEDICARE cover this procedure to instill the future of our younger generation. More and more the younger genereation is showing up with colon cancer. We need to stress the importance of getting tested and need the support of having this procedure covered. The younger generation is thought often to be too young to have such cancer, but the less we test and the more people end up with cancer in late stages the more cost to MEDICARE.

Lynch, Ann-Marie Title: Executive Vice President
Organization: Advanced Medical Technology Association (AdvaMed)
Date: 03/06/2009
Comment:

Charlene Frizzera, Acting Administrator
Centers for Medicare and Medicaid Services
Department of Health and Human Services
7500 Security Boulevard
Mail Stop C5-11-24
Baltimore, Maryland 21244-1850

Re: Coverage of Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N)

Dear Ms. Frizzera:

The Advanced Medical Technology Association (AdvaMed) welcomes the opportunity to comment on the proposed decision memorandum that the Centers for

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Hoffmeister, Jeff Title: Vice President, Medical Director
Organization: iCAD
Date: 03/06/2009
Comment:

March 6, 2009

Mr. William Larson, MA
Centers for Medicare and Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850

Re: NCA for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG- 00396N); Comments on Proposed Denial of Coverage

Dear Mr. Larson:
I am writing on behalf of iCAD, Inc. to submit comments regarding your proposed decision to deny coverage for Screening Computed Tomography Colonography (CTC) for Colorectal

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Kaess, M.D., H. Walter Date: 03/06/2009
Comment:

As a retired surgeon, I am well aware of the benefits of cancer screening. I am also aware of the potential risks and complications of a screening colonoscopy. As you know they include bleeding, perforation, need for unexpected hospitalization, emergency surgery, temporary or permanent colostomy, sepsis and even death. If I told a female patient that there is a 0.5 - 1 in a thousand chance that here breasts might be temporarily or permanently injured by a screening mammogram, or a male

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Imperiale, Tom Organization: Indiana University School of Medicine
Date: 03/06/2009
Comment:

Dear CMS

We are writing in response to CMS’ decision not to assign a CPT code to computerized tomographic colonography (CTC), also known as “virtual colonoscopy”.

While we appreciate CMS' use of the USPSTF evaluation (which gave CTC a category “I” recommendation overall because of insufficient evidence that CTC improved net outcomes for average risk Medicare individuals undergoing colorectal cancer screening when compared to optical colonoscopy), we suggest that certain important

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Inamdar, Nikhil Title: MD
Date: 03/05/2009
Comment:

Re: NCA for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N); Comments on Proposed Denial of Coverage

Dear Mr. Larson:

The recent CMS proposed denial of coverage for CT Colonography (CTC) is based upon a flawed comparative premise and demonstrates an incomplete understanding of the field of colorectal cancer (CRC) screening. In addition there are data input flaws that invalidate the cost-effectiveness analysis, and several misconceptions

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Hayes, Jean Date: 03/05/2009
Comment:

I believe we need to have CTC for Colorectal cancer screening. I know people that would not go otherwise because they are afraid of the test and this makes it less invasive.

Wise, David Date: 03/05/2009
Comment:

The decision to deny coverage for virtual colonoscopy is disappointing. Virtual colonoscopy is a safe and effective means for diagnosing colorectal cancer and should be reimbursed.

Baumel, Mark Title: CEO
Organization: Colon Health Centers of America, LLC
Date: 03/05/2009
Comment:

March 5, 2009

Mr. William Larson, MA
Centers for Medicare and Medicaid Services
7500 Security Blvd.
Baltimore, MD 21244-1850

Re: NCA for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N); Comments on Proposed Denial of Coverage

Dear Mr. Larson:

The recent CMS proposed denial of coverage for CT Colonography (CTC) is based upon a flawed comparative premise and demonstrates an incomplete understanding of the field of

More

Giangrasso, Claire Date: 03/04/2009
Comment:

[PHI Redacted] has just completed 9 months of treatment for colon cancer. He waited longer to have a colonoscopy than he would have waited for a CTC. This test holds the potential to save thousands of lives because people would be less reluctant to undergo this procedure. Please reconsider your policy and include this as a Medicare aprroved procedure.

Veitschegger, Jr,, MD, Rodney Title: Owner
Organization: Western Kentucky DiagnosticImaging
Date: 03/04/2009
Comment:

CT Virtual colonoscopy fits the definition of a "screening" tool. In the setting of an asymptomatic patient of appropriate age, history, etc., it is a relatively low-cost non-invasive, proven effective method to exclude significant lesions of the colon - in addition to the fact that it can identify pathology outside the colon, within the region of examination.Several recent studies have attested to it''s effectiveness.There is certainly some "turf" concern within the colonoscopy

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Rapp, Doreen Date: 03/03/2009
Comment:

PLEASE reconsider allowing the CTC for colorectal cancer for those on Medicare. There are many elderly people with heart problems who are on bloodthinners and can''t have colonoscopies as a result. I know from personal experience that colonoscopies are a very important & necessary diagnostic tool for the prevention & treatment of colorectal cancer. Please don''t eliminate this segment of the elderly from this important test.

degidon, lucy Title: artist/art teacher
Organization: NW bronx for Change
Date: 03/03/2009
Comment:

To all concerned:

[PHI Redacted] I urge the coverage of screening computed tomography colonography (ctc) for colorectal cancer. [PHI Redacted]

Many people could benefit from early detection, if the test was less invasive. removing the emotional fear, and if it were covered by their insurer.

Lucy Degidon

William, Husum Title: President, MD
Organization: Rogue Valley Physicians
Date: 03/03/2009
Comment:

It is hard to imagine that CMS would stand in the way of colon screening, CTC, when so many Americans will die of cancer of the colon. The evidence is in. The time has come for CTC. CMS loses credibility with this short sighted policy. William Husum MD

Rosenberg, Ruth Date: 03/03/2009
Comment:

I have heard that Medicare just announced its intention to not cover virtual colonoscopies. I am [PHI Redacted] an advocate who believes this is a serious mistake.

Medicare coverage of traditional colonoscopy resulted in a tremendous increase in screening rates that has resulted in decreased incidence of and deaths from CRC. Far less effective screening methods are currently covered by Medicare. The virtual colonoscopy is an important tool in the menu of screening

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Richardson, Evan Title: Taxpayer
Organization: US Citizen
Date: 03/03/2009
Comment:

Please see to it that virtual colonoscopy screening is covered under Medicare, it is very important to use all means possible to diagnose this disease early to prevent ever increasing health care costs because someone couldn''t afford the test. It costs less money to test and treat early versus no test and treating after the cancer has gotten a foothold in the patient.

Wallace, Britt Title: R.NCS.T.
Organization: NeuroDiagnostic Laboratories
Date: 03/03/2009
Comment:
How can you not cover Virtual Colonoscopy? There are plenty of studies to prove that they are effective and absolutely many times more effective than no screening at all or even some of the other options Medicare does cover. A huge benifit of this type of screening is especial to those who frightened by procedure and those that are unable to go through it. This is unacceptable to me, especially if, this were available, perhaps [PHI Redacted] would still be here

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Whitney, David Date: 03/03/2009
Comment:

I believe that CTC should be an alternative to colonoscopy. The following research indicates that it is an effective alternative:

Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]Colorectal cancer screening saves livesCoverage of Virtual Colonoscopy will result in the

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Samaraweera, Ranji Title: Chairman Department of Radiology
Organization: Sparrow Hospitals and Clinics
Date: 03/03/2009
Comment:

This seems an unfortunate decision for many patients who will benefit from Colorectal Cancer screening. There is published evidence that CTC is at least as good as Endoscopic Optical Colonography (EOC). NEJM articles have indicated CTC can be superior to EOC. There are clearly examinations that are currently covered such as Barium Studies and Sigmoidoscopy which are clearly inferior to CTC.

Some patients delay EOC out of fear and would welcome the opportunity for CTC screening. Our

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Kase, Daniel Date: 03/03/2009
Comment:

I strongly oppose the proposed CMS plan to deny coverage for virtual colonoscopy. For the following reasons:

Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

Colorectal cancer screening saves lives

Coverage of Virtual Colonoscopy will result in the

More

Griffin, Janis Date: 03/03/2009
Comment:

Please consider coverage of CT virtual colonography as a method for screening for colon cancer. [PHI Redacted] I am aware of numerous studies on the internet verifying the effectiveness of this type of examination and its superiority over lesser tests which remain covered ( fecaoccult blood, flexible sigmoidoscopy and Barium enema ). Numerous friends of mine have also avoided screening up to this point for similar reasons. I believe coverage of this examination will lead

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GRIFFIN, GARY Title: MD
Organization: TORRINGTON RADIOLOGISTS PC
Date: 03/03/2009
Comment:

I would strongly urge CMS to consider Medicare coverage for Virtual Colonography procedures. I am aware of numerous people who have continued to avoid optical colonoscopy due to the possible risks of perforation, the need for anesthesia and the loss of work time to have the procedure performed. [PHI Redacted] However, many individuals may not have that luxury. Increased screening will lead to more lives saved and possible lowered costs in treating colorectal cancer. I

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Dittman, Andrea Date: 03/02/2009
Comment:

[PHI Redacted] was diagnosed with Stage IV colon cancer last year and is now struggling for his life and will probably not make it past the 5 year mark. One of the reasons he did not get screened for colon cancer is that the procedure was not covered by insurance. Although I do not know his current medical bill total, I''m sure it''s close to $100,000 or more. If he''d been able to cover the small cost of screening, his family would not be having to worry about covering

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Henderson, James Title: MD
Organization: Troy Internal Medicine
Date: 03/02/2009
Comment:

I am a private physician in Internal Medicine and take care of about 3500 patients. Screening for colon cancer is stressed but completed at a low rate due to preparation, anesthesia, risk of perforation and day lost from work with a driver required. I have found CTC a more acceptable option [PHI Redacted]. With an experienced reader and trained technicians this test is easy to perform and all of the above bypassed except the prep. We do them in the AM and if something

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Koeniguer, Mark Date: 03/02/2009
Comment:

Colorectal Cancer is one of the leading causes of death in the U.S. [PHI Redacted] CTC offers a low cost, now low dose and non-invasive method to screen for this disease compared to the alternatives.

Using our most advanced technology, CT, to help fight this disease only makes sense and we should open up this technology to all so that we can utilize all early detection methods possible.

Similar to the fight against Breast cancer, Colon cancer can be

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Kanarowski, Madelene Date: 03/02/2009
Comment:

Please allow Computed Tomography for Colorectal Cancer for mediacare patients with payment covered.

DiCiccio, Deborah Date: 03/02/2009
Comment:

I am very disappointed that you have found CTC not reimbursable. it is a fantastic alternative to regular colonoscopies, minimally invasivasive and provides diagnostic results.

I am hoping that you will go back and review your results for a favorable opinion. Thank you

hagman, joseph Date: 03/02/2009
Comment:

excellent, safe, and cost-efective screening tool for colorectal cancer. much cheaper than routine colonoscopy. i don''t understand why medicare would not reimburse for this.

Ahnen, Dennis Title: Staff Physician and Professor of Medicine
Organization: Denver VA Medical Center and University of Colorado Denver School of Medicine
Date: 03/02/2009
Comment:

I am a Gastroenterologist, I believe in colonoscopy and I spend a lot of my time doing screening colonoscopy. I was disappointed to learn of the proposal to not include CT colonography as an acceptable and reimbursable option for colon cancer screening. I think this is a mistake. I would endorse Medicare reimbursement for CT Colonography for the following reasons.
1. It is now well established that CT colonography, if done by well trained radiologists with state of the art equipment,

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Cothren, Joyce Date: 03/02/2009
Comment:

Colorectal screening saves lives and coverage of CTC will result in screening of patients who otherwise might not follow through with optical colonoscopy (diverticulosis makes optical painful, less so with CTC).

This is a very cost effective method to screen patients and demonstrates so much more than optical colonoscopy (ascending colon especially) reference the reverse fly through as well as diviticulae and other abdominal organs that are not seen on optical colonoscopy.

Chestnut, Janet Date: 03/02/2009
Comment:

I am a practicing medical oncologist and serve as cochair of cancer screening for Group Health. I agree and applaud your decision to not approve virtual colonography as a screening procedure for colorectal cancer. There is not sufficient evidence on its efficacy or effect on outcome to justify its approval. I alos applaud your use of USPSTF guidelines. They are evidence based and free of political bias.

Stratigeas, Betty Date: 03/02/2009
Comment:

THIS IS MANDATORY THAT EVERYONE HAVE THEIR COLONOSCOPY DONE.

THANK YOU,
Betty
Seigel, M.D., F.A.C.R., Robert Title: M.D., F.A.C.R.
Organization: Rural Radiology Associates, P.L.L.C.
Date: 03/02/2009
Comment:

Dear Dr. Phurrough,

I am writing as a concerned citizen more so than experienced reader of ct colonographic exams. [PHI Redacted] both died in the last three years as a result of metastatic colon carcinoma. I strongly believe in screening and am convinced that the ct approach is valid and valuable to individuals over the age of 50 as a screening tool.

[PHI Redacted]

The article by Kim and Pickhardt in NEJM in 2007 with over

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Haley, Tom Title: Operations
Organization: Colorado Heart & Body Imaging
Date: 03/02/2009
Comment:

TO WHOM IT MAY CONCERN AT CMS:

For once, can decisions be made without the politics of enriching special interst groups ie. (GI DOCTORS), over the public''s well being!!!

1. The American Cancer Sosciety has endorsed the virtual colon fro colon screening in March 2008 after the studies confirming its efficacy was overwhelming.

2. 92% of all optical colonoscopies fail and this number becomes suspect when its now known that conventional colonoscopy was not associated

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Murphy, Kate Date: 03/02/2009
Comment:

[PHI Redacted]

When I talk to friends [PHI Redacted] they are still reluctant to have colonoscopies. They talk about pain, having something "stuck up their rear ends", and some know of people who have had colons perforated.

Having CT colonography available for them would make screening possible.

At least they could make a choice.

Please reconsider your decision not to cover this option for older people like me.

Schnipper, Eric Title: Partner
Organization: Nassau Radiologic Group
Date: 03/02/2009
Comment:

In “Proposed Decision Memo for Screening Computed Tomography Colonography (CTC) for Colorectal Cancer (CAG-00396N), the proposed decision memo states that the analytic framework for screening tests involves consideration of several different factors compared to diagnostic tests and therapeutic interventions. CMS states that “the evaluation of screening tests has been standardized and accepted” and utilizes as a framework the criteria set forth by Cochrane and Holland in 1971.

I will

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Vitellas, Kenneth Date: 03/02/2009
Comment:

Based on multiple scientific articles, CTC has been shown to be a very accurate screening exam, with less cost and less risk than optical colonoscopy. It is the many millions of Americans, especially those who opt out of optical colonoscopy (half of the screening population) who would benefit from this exam. Here are some articles that state benefits of CTC.

Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD,

More

Hart, Kevin Title: Interim Director Radiology
Organization: University Health System
Date: 03/02/2009
Comment:

Colorectal cancer screening saves lives Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy.

CMS should cover virtual colonoscopy because multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]. In addition,Virtual

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vu, loi Date: 03/02/2009
Comment:

I hope you will fund ctc. It is a noninvasive, no risk, and equally effective screening test as traditional colonoscpy. There are many studies reported in the medical literature demonstrating this tests effectiveness as a screening study. I myself would prefer to have ctc rather thant endoscopy.

Patella, Dominick Date: 03/02/2009
Comment:

In the past year or so I have been speaking with people that have serious concerns with traditional colonoscopy protocol of receiving anesthesia. I was also surprised to hear patients are educated enough to understand the risks of bowel perforation. These concerns keep patients from having traditional colon screening. They instead would like to have a virtual colonoscopy but do not want to pay out of pocket which now has them avoiding colon screening totally. I was hoping that in 2009

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Gieles, Paul Date: 03/01/2009
Comment:

Dear Madam/Sir,

I believe that the screening for colorectal cancer is by means of CT (Virtual Colonoscopy)is an important and possibly life saving procedure.

Also, multiple studies have proven the advantageous results compared to optical screening and therefore should be reimbursed.

I therefore hope you will reconsider your intended negative decision on CTC.

Paul Gieles
Oncology Program Manager
Philips Healthcare

Hubbert MD, Theodore Organization: Medford Radiological Group
Date: 03/01/2009
Comment:

The AGA has stated there are not enough GI specialist to perform all the needed colonoscopy screening exams in our aging population. Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200] Colorectal cancer screening saves lives Coverage of Virtual Colonoscopy will result in the

More

Margolis, Daniel Title: Assistant Professor of Radiology
Organization: UCLA David Geffen School of Medicine
Date: 03/01/2009
Comment:

I should first disclose that I am a radiologist and am in charge of virtual CT colonography (CTC or VC) at the University of California, Los Angeles David Geffen School of Medicine. I also perform air-contrast (or double-contrast) barium enemas (ACBE or DCBE) for the screening of colon polyps and cancer. I do not advocate for CTC over conventional colonoscopy as the primary method of colon polyp and cancer screening. However, for a subset of the population it is the best choice, as it is

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Baumel, Rita Date: 03/01/2009
Comment:

I am writing to voice my strong disagreement with Medicare’s recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American’s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

Why did Medicare not acknowledge that more than 50% of Americans have not, will not, or cannot receive traditional colonoscopy as a

More

Tibbetts, Todd Date: 03/01/2009
Comment:

To whom it may concern:

Although colon cancer screening is well documented to save lives, only a minority of eligible patients undergo regular colon screening. There is a significant need for a safe, accurate, and well tolerated test to supplement our current screening strategy.

Numerous studies have shown that CT colonography is an effective screening examination for colon cancer, similar in effectiveness to optical colonoscopy.(1,2,3) In addition, it is clearly more sensitive

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Marcus, David Date: 03/01/2009
Comment:

Preventing or treating early colon cancer is good for the individual and Society.

Sceening as inexpensively and safely and least invassively is ideal.

Colonoscopies are expensive to the patient and society. Patients and families take time off for work. Many resources are utilized. There are complications.

CT Colonography solves many of these problems and costs and dangers.

However, it is disruptive technology. Many hospitals, outpatient colonoscopies

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Wazny, Dana Title: concerned citizen
Date: 03/01/2009
Comment:

Kaiser Permanente Center for Health Research has just completed an evidence review and released findings that computed tomographic colonography (CTC) is just as effective as colonoscopy at detecting cancerous lesions, only it''s non-invasive. This method is simply a CAT scan so more people may be willing to be screened and therefore more cancers detected early on. In addition, the majority of healthcare costs come from treating chronic diseases including cancer, which is why preventive

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Taylor, William Date: 02/28/2009
Comment:

I believe that the decision regarding screening colonography should be revisited in view of the following:

  • Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]
  • Colorectal cancer screening saves lives
  • Coverage of Virtual Colonoscopy will result in the

    More

  • Nelson, Dana Date: 02/28/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    Colorectal cancer screening saves lives

    Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy Virtual Colonoscopy is more sensitive than other

    More

    Dixon, George D Title: Interventional Radiologist
    Organization: Saint Lukes Hospital
    Date: 02/28/2009
    Comment:

    CTC should be paid for by CMS for the following reasons:

    1. The ability to find significant lesions isvirtually as good as colonoscopy.
    2. The biopsy rate is significantly less.Therefore less cost to CMS.
    3. Significant complications are significantlyless.
    4. The number of significant lesions found elsewhere (cancers, aneuryisms, etc) is equal to the signicant complication rate of colonoscopy. Thus a significant side benefit.
    5. Patients with

      More

    Kalapparambath, Annie Date: 02/28/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200] Colorectal cancer screening saves lives Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy Virtual Colonoscopy is more sensitive than other screening methods which

    More

    Kalapparambath, Tomy Date: 02/28/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200] Colorectal cancer screening saves lives Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy Virtual Colonoscopy is more sensitive than other screening methods which

    More

    PETERKIN, IAN Date: 02/28/2009
    Comment:

    HELLO, I AM A DIAGNOSTIC RADIOLOGY PHYSICIAN IN THE DC AREA. YOUR DECISION TO NOT COVER CTC IS WRONG AND WILL NEGATIVELY IMPACT ON THE ABILITY OF THE MEDICAL COMMUNITY TO PREVENT AMERICANS FROM DYING OF COLON CANCER. OF ALL THE CANCERS THAT EXIST, COLON CANCER IS ONE OF THE FEW GOLDEN OPPORTUNITIES THAT WE HAVE TO DETECT AND ELIMINATE THE DISEASE AT THE PRECANCEROUS STAGE, BEFORE IT EVEN BECOMES A MALIGNANCY. OPTICAL COLONOSCOPY (0C) IS OF COURSE EXCELLENT AS WELL, THOUGH NOT WITHOUT ITS

    More

    roos, ken Date: 02/28/2009
    Comment:

    I was shocked to hear of the CMS ruling on virtual colonoscopy. With very low screening rates for CRC, this effective, non-invasive and patient-friendly screening test is desperately needed. Multiple studies have been done and its efficacy has been confirmed. Please reconsider this decision. Save lives!

    Beasley, MD, H. Scott Title: Asst. Professor Diagnostic Radiology
    Organization: University of Pittsburgh Medical Center
    Date: 02/28/2009
    Comment:

    As a radiologist, I have extensive experience in performing air contrast barium enema exams and CT colonography. There is no question that CT colonography is a much more sensitive and reliable exam for detecting polyps/colorectal cancer. I believe it is a mistake not be using CTC as a screening tool for colorectal cancer. There are many patients who would have CTC but are unwilling to undergo colonoscopy or barium enema. We need to focus on getting as many at risk people in the

    More

    Robbins, Ken Date: 02/28/2009
    Comment:

    CT colonography is a safe , effective alternative to screening endoscopic colonoscopy. CT colonography is a well tolerated outpatient procedure which allows the patient the ability to return to immediate normal activity.

    Barnes, Jeff Date: 02/28/2009
    Comment:

    I urge CMS to approve reimbursement for CTC. As a taxpayer, I am convinced this non-invasive procedure will save the country money. It will also importantly increase the compliance rate amongst Americans - thus saving lives. My understanding is that private payors are already reimbursing for CTC. It just makes too much sense. Don''t let the gastroenterology community negatively influence this decision. Do the right thing for Americans!

    Kadam, Pankesh Title: President
    Organization: AmScan Radiology
    Date: 02/27/2009
    Comment:

    CMS should provide the leadership in approving coverage for CTC which is a safe, effective and much better procedure as compared to optical colonoscopy. It is also less costly and does not require sedation.I strongly urge CMS to reconsider its decision for denial of coverage for CTC.

    Deshmukh, Sandeep Date: 02/27/2009
    Comment:

    Given the large volume of data available on the utility of screening CTC for colorectal cancer and the large number of people who need colorectal cancer screening, I feel that not using this modality for screening is in essence the equivalent of delaying or denying timely healthcare to patients.

    Kaakaji, Yazan Date: 02/27/2009
    Comment:

    Not enough GI docs to screen everyone.
    YK

    McDonald, John Title: Medical Practice Division Administrator
    Organization: John C. Lincoln Health Network
    Date: 02/27/2009
    Comment:

    I lost a PHD-well educated [PHI Redacted] who feard having a colonscopy and she died before the age of 50 due to colon-rectal cancer. If a virtual colonoscopy had been availible I am sure she would have had herself screened and might be alive today. As you surely know, there are multiple studies that have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med

    More

    cihura, april Title: DIRECTOR OF RADIOLOGY
    Organization: AVRMC
    Date: 02/27/2009
    Comment:
  • Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]
  • Colorectal cancer screening saves lives
  • Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy
  • Virtual Colonoscopy is more sensitive than other

    More

  • Lee, Joanne Date: 02/27/2009
    Comment:

    There is strong research showing that CTC is a minimally invasive and cost effective method of detecting and staging colon cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]. Virtual Colonoscopy is more sensitive than other screening methods which are already covered by Medicare, such as flexible sigmoidoscopy and double contrast barium enema. [Imperiale, TF, et al. N Engl J

    More

    Davis, Susan Title: Provider Relations Liaison
    Organization: Rochester Radiology Assoc
    Date: 02/27/2009
    Comment:

    CTC for colorectal cancer is extremely important. Many times a colonoscopy is incomplete because the MD can not get through the study. These patients need to have an alternative exam which gives accurate findings.

    DuBois, Mary Lou Date: 02/27/2009
    Comment:

    [PHI Redacted] had the traditional colonography several years ago. He had to take off worrk and so did I in order to take him for this procedure. It''''s at least a half day and usually more depending on if your appointment time on time. This year he chose to have the virtual colonography and had a 7:30 a.m. appt. and was finished in 30 minutes and was able to go back to work. He did NOT have to be put to sleep and a recovery period. I didn''''t have to take off work for

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    Rohan, James Date: 02/27/2009
    Comment:

    I would like the option of having a CTC prior to needing a therapeutic colonoscopy for polyp or other removal. Please do no not take this option away from me and others.

    Bogoni, Luca Date: 02/27/2009
    Comment:

    I believe that CTC would be a valuable technology for the screening of Colorectal cancer. It has been proven to provide a strong sensitivity and is less invasive that OC. Newer technologies such as CAD should also help in standardizing the performance of radiologist so that they would perform at the level of experts. I believe that, with future preparations that will not be cathartic, it will be possible for the patient not to loose a whole day to get receive OC rather, could follow an

    More

    Hollenbacher, Dean Title: Advanced Visualization and 3D Specialist
    Organization: Lancster General Hospital
    Date: 02/27/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    Colorectal cancer screening saves lives

    Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy

    Virtual Colonoscopy is more sensitive than

    More

    Jacoby, Robert Title: Administrative Director Radiology
    Organization: Pomona Valley Hospital Medial Center
    Date: 02/27/2009
    Comment:

    CMS seems to continue the practice of denying the use of technology rather than supporting it''s use in the diagnosis of health problems. CT colonoscopy has been demonstrated to be a valuable asset in the detection of colon related problems and yet CMS only looks to deny rather than support new technology.

    Dillman, Jaqueline Date: 02/27/2009
    Comment:

    Please do not deny coverage for digital Colonoscopy for colorectal cancer screening. You reduce the number of people who will have this life saving procedure - those resistant to Optical. The sensitivity of digital is good and its funding will continue the development of more inexpensive digital solutions.

    Purcell, Troy Date: 02/27/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    Colorectal cancer screening saves lives Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy

    Virtual Colonoscopy is more sensitive than other

    More

    Bonnett, John Date: 02/27/2009
    Comment:

    re: CMS Virtual Colonoscopy (CTC) coverage decision.

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    In addition, in research published by PJ Pickhardt in 2007, CTC and OC screening resulted in similar detection rates for advanced neoplasias while significantly less

    More

    Handley, Matt Date: 02/27/2009
    Comment:

    As the Associate Medical Director for Quality and Informatics at Group Health Cooperative, I am heartened that CMS has set a reasonable bar for approval of a technology for use in screening. The "theory of possible benefit" is a poor substitute for properly designed trials to evaluate the impact of a screening intervention on disease specific mortality. This decision reflects a reasoned stance that puts the burden of proof on the intervention, an appropriate standard for a screening

    More

    Buist, PhD, MPH, Diana Title: Associate Scientific Investigator
    Organization: Group Health
    Date: 02/27/2009
    Comment:

    This is a critically important coverage decision that demonstrates important leadership. Aligning coverage decisions with USPSTF guidelines is an important step forward to coverage decisions that are aligned with the evidence. There should be increased investment from the government to bridge the evidence gaps for USPSTF "I" statements to move them towards a "A or B" recommendation or shift these to "D" recommendations. There is likely a tremendous amount of waste in health care delivery

    More

    Haswell, James Date: 02/27/2009
    Comment:

    This is a classic example of why healthcare should not be nationalized. CTC was developed over 10 years ago and has been validated in multiple studies. CTC will increase the screening rate for colon cancer and decrease costs by eliminating the need for some colonoscopy. I thought we were trying to reduce healthcare costs. I suggest CMS for once use some common sense.

    Borgnes, Kimber Date: 02/27/2009
    Comment:

    I am very disappointed that CMS did not approve of payment for CTC as a screening exam.

    CTC does not have to be better than traditional colonoscopy, it just has to be better than screening barium enema - which it is.

    There is absolutely no reason that we consumers should have to settle for traditional optical colonoscopy. As a screening exam, it has potential for serious complications - including perforation and death, which is absurd. CTC has proven itself again and

    More

    Hale, Debra Date: 02/27/2009
    Comment:

    I am disappointed to here the CMS is proposing to NOT cover virtual colonography! Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200] Colorectal cancer screening saves lives!Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical

    More

    girshek, teven Date: 02/27/2009
    Comment:

    The use of CT for colonoscopy has provided a positive alternative to the long and uncomfortable process of a standard colonoscopy. It is my belief, based upon personal knowledge, that it has gotten many people to get a needed colonoscopy screening when they had not and would not have gotten one with the traditional methods due to fear and potential bad reactions. Additionally, there is the reduced cost to consider of the use of a full fledged ASC.I hope that CMS does not recommend ending

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    Slasinski, Steve Date: 02/27/2009
    Comment:

    To Whom It May Concern:

    Please reconsider your decision not to reimburse for CTC. This test has proven to be effective and the number of lives it can impact is tremendous. I strongly urge you to re-open your investigation to this valuable test.

    Sincerely,

    Steve Slasinski

    Baker, Keith Date: 02/27/2009
    Comment:

    I feel that you should relook at ALL the studies that have been done and get with the times. Something is better than nothing. Hospital stay, meds, ect vs a quick CT scan. The ct scan would then justify a real colon study, thus justifying the hospital cost. I myself, would and will payu cash for a virtual before going thru the hospital one.

    Mackey, M.D., J. Kevin Date: 02/26/2009
    Comment:

    I firmly believe that CT Colonography is equal or better as a screening device to actual colonoscopy for the detection of colorectal cancer. CT Colonography is technically better than actual colonoscopy because it does not require conscious sedation, takes less patient time, takes fewer healthcare man hours to perform, is not an invasive procedure, and can always examine the entire colon to the cecal tip and behind folds in the colon wall (which actual colonoscopy cannot). CT Colonography

    More

    Finer, Richard Title: Radiologist
    Organization: Boulder Radiologists, Inc.
    Date: 02/26/2009
    Comment:

    I am a Radiologist in Boulder, Colorado and understand the difficulty of performing an air contrast barium enema. I feel like we are doing a disservice to the public when we have such a better test in CT virtual colonscopy to offer to individuals. Plus virtual colonoscopy is better tolerated and will be more accepted by patients as long as it is covered by insurance. To be honest, CTVC takes much more time for me to interpret than a routine BE, however, I feel it is a much better exam

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    Cook, Perry Date: 02/26/2009
    Comment:

    CTC has been shown in multiple trials to have excellent sensitivity and specificity for the detection of significant colon cancer/polyps. There is no question that it should be added as a reimbursed screening method for colon cancer. One argument against CTC is the fact that a biopsy can not be performed at the same time. That is as absurd as saying we should not do screening mammography because a biopsy can''t be performed at the same time. Another argument is that some patients will have

    More

    McAninch, Gregg Date: 02/26/2009
    Comment:

    Screening with CT for colorectal cancer is very cost effective, safe and effective tool and should be funded for reimbursement. More patients screened will mean more patients saved Period.

    Egger, Claire Title: Radiology Manager
    Organization: QLIMG
    Date: 02/26/2009
    Comment:

    * Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    * Colorectal cancer screening saves lives

    * Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy

    * Virtual Colonoscopy is more

    More

    Corse, William Date: 02/26/2009
    Comment:

    CTC for Colorectal Cancer screening is a well proven cost effective means to help encourage screening of the 50% of our population that does not currently undergo optical colonoscopy as per national guidelines. There is little doubt as to its efficacy when performed by properly trained Radiologists. Please do not let politics negate good medical care.

    Dodaro, Matthew Date: 02/26/2009
    Comment:

    I can understand the difficulty in making the decision to fund screening CTC and I do understand that there are still questions. I would like to make two seperate points.

    1. As a practicing radiologist who was recently finished my training and who was trained in performing CTC exams during fellowship and currentlty performs CTC I look at the currently reimbursed screening procedures and have to question why CTC is not included. Surely I understand that a case can be made optical

    More

    Getchel, Joseph Date: 02/26/2009
    Comment:

    - Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    - Colorectal cancer screening saves lives

    - Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy

    - Virtual Colonoscopy is more

    More

    Genser, Ronelle Date: 02/26/2009
    Comment:

    The following comes from Lewy Body Dementia Association''s (www.lbda.org) 2007 ''Facts about LBD'' pamphlet. Note: Lewy Body Dementia (or LBD) is the 2nd most common form of dementia in the United States.

    “When considering any surgery, caregivers should meet with the anesthesiologist in advance. ''People with LBD often respond to certain anesthetics and surgery with acute confusional states (delirium) and/or may have a precipitous drop in functional abilities which may or may not be

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    Earnest, Tom Title: DIrector of Radiology Services
    Organization: Lutheran Hospital of Indiana
    Date: 02/26/2009
    Comment:

    I am in favor of the CMS approving screening CT Colonography for colorectal CA. The American Cancer Society has done it''s dilgence on the procedure and has approved it as an acceptable screening procedure for colon CA. The latest large scale study that was just published also concluded that it is just as accurate as screening colongraphy.

    It is a much less invasive procedure then a screening colonography it is also a less costly procedure then a screening colonography. Proven to

    More

    Roybal, Donald Date: 02/26/2009
    Comment:

    I believe this to be a very important tool in the detection of colon cancer. The total disregard for this test or procedure would be greatly misstated by the wave of a hand and the procedure deserves a chance in developing futher.

    Zuber, Sarah Date: 02/26/2009
    Comment:

    In a recent, high quality systematic evidence review published by the US Preventive Services Task Force, CTC was shown to be equally effective in detecting cancerous lesions as colonoscopy. Due to the non-invasive nature of the test, people will be more likely to be screened, cancers detected early, and therefore have a more positive prognosis. In addition, as the majority of healthcare costs come from treating chronic illness including cancer, preventive medicine is so incredibly

    More

    Fitzgerald, James Date: 02/26/2009
    Comment:

    Many patients who won''t or can''t have an optical colonoscopy will have a CTC. This will ultimately lead to cost savings by detecting premalignant polyps and cancers at an earlier stage. It will also lead to less human suffering. Many private insurances follow medicares lead. Be a leader and cover this procedure.

    Hennen, Ryan Date: 02/26/2009
    Comment:

    I have seen first hand the ability of CTC to saves lives. I think that this denial and delay of insurance coverage has gone on for long enough.

    Help the people that need to be screened get screened for Colon Cancer, and approve this method!

    Deem, Brent Title: Diagnostic Radiologist
    Date: 02/26/2009
    Comment:

    I am a radiologist who has been trained by the American College of Radiology to perform and interpret Virtual Colonoscopy exams. This exam could save countless lives every year and save the government a lot of money by finding polyps sooner so that they can be removed before becoming cancer. VC is better than flexible sigmoidoscopy and barium enema in detecting colon polyps and cancer and yet these are paid for by the CMS. Many peoples lives could be saved by VC, so PLEASE help us medical

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    Miller, Jay Date: 02/26/2009
    Comment:

    As a member of the Board of the Midwest Division of the American Cancer Society, I think that it is incredibly important to take a hard look at the long-term cost savings of preventing colon cancer by offering CTC as a colon cancer screening option; not the short-term savings. In fact, I think it''s embarrassing that so many people still die of a form of cancer that is nearly 100% preventable with proper screening. I see CTC as even more important than mammography in finding cancer early

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    Champine, John Date: 02/26/2009
    Comment:

    I was Software Engineering & Project Manager responsible for one of the first integration of colon CAD into the premier radiological visualization software system used by thousands of radiologists throughout the world. This was in support of the first & second Pickardt et al sudy which conclusively proved the effectiveness of Virtual Colonoscopy compared to traditional methods. To deny reimbursement for colorectal cancer screening is absurd. Can we assume that next you will only reimburse

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    Harrison, Anne Date: 02/26/2009
    Comment:

    I urge you to continue to reimburse physicians who through Medicare and Medicaid request and prescribe CTC screening as a way to try and detect colorectal cancer. Anything that can make earlier detection of cancer possible and more likely for a greater number of people should be supported. I would also urge standard screening to be moved back from 50 to 40 years of age. [PHI Redacted] was diagnosed with colorectal cancer (stage 3) at 42. He had no risk factors for the

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    Flinn, Carol Title: Chief Executive Officer
    Organization: Rogue Valley Physicians
    Date: 02/26/2009
    Comment:

    I am writing to strongly encourage CMS to approve screening CT colonography (CTC) coverage for CMS beneficiaries. Colorectal cancer (CRC) is one of the most preventable cnacers there is, yet is is the second leading cause of cancer related deaths in the U.S.as less than half of our population gets age appropriate screening. CTC provides a safe and effective method of screening that many people will be more inclined to undergo than traditional screening such as optical colonoscopy.

    More

    MANI, RAVI Date: 02/26/2009
    Comment:

    50 % of the eligible population is not being currently screened with standard colonoscopy.Colon cancer prevention will save significant health care dollars by preventing colon cancer. The science supports the use of Virtual colonsocopy as a screening modality.

    Fulmer, Merryl Title: Clinical Trials Trainer
    Organization: American College of Radiology
    Date: 02/26/2009
    Comment:

    I think it is absolutely necessary for CTC to be APPROVED for colorectal cancer screening. The clincal data certainly supports its efficacy regarding the sensitivity and specificity. Other advantages and benefits include the fact that many people AVOID having a conventional colonoscopy due to the nature of the study, the cost involved, the anesthesia used, the time needed to prep and have procedure, a whole day or two of work missed. The minor disadvantages would include the inabilitly of

    More

    Gagliolo, Jim Date: 02/26/2009
    Comment:

    I disagree with the recent ruling to deny reimbursement for virtual colonoscopy procedures. There are too many viable patients waiting for this procedure due to the inherent benefits of speed, convenience (as opposed to the conventional barium or scope studies) and a high degree of accuracy. Reconsideration and reversak of the initial ruling is warranted,

    Toubia, Souhail Title: M.D.
    Organization: Family Medicine
    Date: 02/26/2009
    Comment:

    Optical Colonoscopy(OC) has failed in reaching to the people at risk:about 20% compliance is a crime.Let''s put politics aside and let''s save lifes. Failure of OC should make Virtual Colonoscopy (VC)a must. All scientific datas and studies support VC.Even if VC misses few cases (and I doubt it), it is easier, less invasive, cost much less, and as accurate as OC if not more.VC will make compliance as high as Mammograpy (75%). [PHI Redacted] (VC by far is more accepted and

    More

    Wellons, Julia Ann Title: Sr. CT Clinical Education Specialist
    Date: 02/26/2009
    Comment:

    I would ask that this decision be seriously reconsidered. I teach CAT scanning and along with that, I teach Virtual Colonoscopy. I submit to you that I was involved at a site where a Radiologist requested to have a VC performed on her since her 2 prior colonoscopies both failed.It took 2 days of proper cleasing but we were able to successfully scan her.It was somewhat difficult to track through 2 narrowed areas. I was able to refer her images to a radiologists that has a great deal of

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    leder, david Date: 02/26/2009
    Comment:

    I have performed over 200 CTC examinations over the past 4 years. These studies have been done on patients who were unable to undergo conventional colonoscopy for medical reason or for those patients who had incomplete colonscopies. The CTC has been an important part of patient care in these instances and literature supports an expanded role in screening for colorectal cancer.

  • Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for

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  • Siegel, MD. FACS, John Title: Surgeon
    Organization: Santa Clara Valley Medical Center
    Date: 02/26/2009
    Comment:

    I am a general surgeon in practice in a small community hospital for 20 years, and now in a Stanford-affilitated county (public) hospital and trauma center. At least 3-4 times a year I have been called emergently to the endoscopy suite to assume the care of a deteriorating patient who was undergoing a screening colonoscopy and who sustained colonic perforation. In several cases recently, death was the clinical outcome despite timely surgical exploration and repair. Discomfort during

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    Peterson, Jed Title: Dr.
    Organization: Albert Einstein Medical Center
    Date: 02/26/2009
    Comment:

    There is strong research showing that CTC is a minimally invasive and cost effective method of detecting and staging colon cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]. Virtual Colonoscopy is more sensitive than other screening methods, which are already covered by Medicare, such as flexible sigmoidoscopy and double contrast barium enema. [Imperiale, TF, et al. N Engl J

    More

    Eisenberg MD, James P Title: PhD RSO FA; Clinical Assistant Professor
    Organization: Univ of Toledo Medical School
    Date: 02/26/2009
    Comment:

    No one should ever die from colon cancer. Colon cancer is 100% curable. 55,000 Americans die needlessly each year from colon cancer. We have a solid program in place for breast cancer screening. Only about 40% of Americans are screened annually for colon cancer; the other 60% are at risk for a curable disease. The scientific studies unequivocally demonstrate that CT colonography (Virtual Colonoscopy) is a robust, proven screening method for colon cancer; and is the preferred

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    Shrivastava, Abhishek Date: 02/26/2009
    Comment:

    There is strong research showing that CTC is a minimally invasive and cost effective method of detecting and staging colon cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]. Virtual Colonoscopy is more sensitive than other screening methods which are already covered by Medicare, such as flexible sigmoidoscopy and double contrast barium enema. [Imperiale, TF, et al. N Engl J

    More

    Kogan, Boris Date: 02/26/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200] Colorectal cancer screening saves lives Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy Virtual Colonoscopy is more sensitive than other screening methods which

    More

    Slone, Jenifer Date: 02/26/2009
    Comment:

    There is strong research showing that CTC is a minimally invasive and cost effective method of detecting and staging colon cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]. Virtual Colonoscopy is more sensitive than other screening methods which are already covered by Medicare, such as flexible sigmoidoscopy and double contrast barium enema. [Imperiale, TF, et al. N Engl J

    More

    Hibner, Robert Title: Director of Radiology
    Organization: Ashland Community Hospital
    Date: 02/26/2009
    Comment:

    We have offered this exam for several months, the study is an excellent screeing tool for the community. A large part of the population still does not screen for colon cancer. This devastating desease is preventable with screening. The ACS lists CTC as a choice for screening. CMS can help save lives by supporting this screening option.

    O''Loughlin, Brian Title: Physician Resident
    Organization: Department of Radiology
    Date: 02/26/2009
    Comment:

    There is strong research showing that CTC is a minimally invasive and cost effective method of detecting and staging colon cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]. Virtual Colonoscopy is more sensitive than other screening methods which are already covered by Medicare, such as flexible sigmoidoscopy and double contrast barium enema. [Imperiale, TF, et al. N Engl J

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    Fischer MD, Paul Title: physician
    Organization: Center for Primary Care
    Date: 02/26/2009
    Comment:

    Dear Sirs:

    I am a family physician and have always seen one of my responsibilities as screening for colon cancer. To be honest, I have not been happy with invasive colonoscopy, as now practiced and have looked forward to your approval of virtual colonoscopy. The invasive technique is expensive, includes a risk of peforation, an anesthesia risk, and the usual practice of numerous biopsies of small hyperplastic polyps. The reimbursement system for all of this has driven GI medicine

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    BADEN, JOHN Date: 02/26/2009
    Comment:

    Please reconsider your stance on virtual colonoscopy with CT. Studies have shown this study decreases overall health costs. Thanks, J. Greg Baden, M.D.

    McQueeney, Julie Title: Center Manager, Wide Open Imaging
    Organization: Wide Open Imaging
    Date: 02/26/2009
    Comment:

    Its so sad to think Medicaid and Medicaire patients that cannot take a conventional colorectal screening, due to their health condition will be unable to have a virtual CT. This is an invaluable tool to the practitioner, and not as an expensive of a modality. I hope this will be an option available to them, because the healthcare provider will end up covering the expense.

    Shawger, Eric Date: 02/26/2009
    Comment:

    The FTC and FCC delays in approving the Sirius XM merger did significant damage to the viability of that combined business. Please don''t fall prey to the same type of thinking. I''m suspicious of the same "competition-fear" lobbying by the Gastroenterology community as satellite radio got from traditional radio. With the end result being far more harmful for US Citizens. [PHI Redacted] How many millions of Americans avoid the invasive screening because they wish to avoid

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    MULLENS, DIANA Title: LEAD MRI TECHNOLOGIST
    Organization: FIRELANDS REGIONAL MEDICAL CENTER
    Date: 02/26/2009
    Comment:

    I FEEL THAT VIRTUAL COLONOSCOPY WITH CT SHOULD BE A COVERED PROCEDURE BY MEDICARE AND MEDICAID AS IT IS LESS INVASIVE AND MUCH SAFER FOR THE PATIENT THAN TRADITIONAL COLONOSCOPY WITH ANESTHESIA. THE EXPENSE AND THE POSSIBILITY OF PERFORATION WOULD BE FAR LESS AND IT WOULD DEFINATELY OFFSET THE FEE AS OPPOSED TO ENDOSCOPY.

    Medlen, Bart Title: President/Owner
    Date: 02/26/2009
    Comment:

    Please note the following statements and reconsider your stance on VC reimbursements.

  • Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]
  • Colorectal cancer screening saves lives
  • Coverage of Virtual Colonoscopy will result in the screening of patients who

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  • Shapiro, Patricia Title: MD
    Organization: SouthCoast Medical Group
    Date: 02/26/2009
    Comment:

    I strongly believe that virtual colonoscopy should be the procedure of choice to screen for colon polyps and cancer. It is less expensive, equivalent accuracy foradomatous polyps >= 5mm and is safer than colonoscopy. Patients that have had both exams consistently report that VC is preferable. No sedation is needed. Addtional abnormalities that can impact patient care such as aortic aneurysms can be detected.

    In summary, VC is good medicine and good financially for Medicare.

    Arnaudo, joseph Title: sr regulatoty manager
    Organization: philips Helathcare
    Date: 02/26/2009
    Comment:

    Screening Computed Tomography Colonography (CTC) for Colorectal Cancer is a major beakthrough in todays medicine. Research has showed the this tecnology works. This needs to be approved for all people to halp save lives.

    Sveningson, Steven Title: Clinical Services Executive
    Organization: First Care Medical Services
    Date: 02/26/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003; 349:2191-200]

    Linden, Dennis Date: 02/26/2009
    Comment:

    I am almost speechless. It is my opinion that one of the greatest rip off''s of CMS is the double and triple dipping of gastroenterologists, who require a pre op consult, performed by an NP, which is a total waste of money given that I a board certified Internist have already performed and examination and have referred the patient for the procedure. Then they often find some reason to perform and endoscopy too, so 3 services are performed at GREAT COST compared to a single test which

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    Bergen, Tom Title: Registered Nurse
    Date: 02/26/2009
    Comment:

    Please reconsider your decision denying coverage for CT virtual colonoscopy.

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy.

    Virtual

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    Williams, Eric Title: MD
    Date: 02/26/2009
    Comment:

    I find it incredible that despite all of the evidence that CT Colonography is a valuable means of assesment for colon cancer, there is consideration for denial of coverage.

    Michael, Robin Date: 02/26/2009
    Comment:

    This is a wonderful tool to screen for colo-rectal cancers. I feel it would be a travesty to deny coverage for this less invasive procedure. Many people will benefit from this exam and more people would be likely to have this done than conventional colonscopies.

    Chen, Dongqing Title: Lead Scientist
    Organization: Viatronix, Inc.
    Date: 02/26/2009
    Comment:

    [PHI Redacted] was die last November due to the colon cancer.[PHI Redacted] I always follow the research publications on colon cancer screening. In recent years, the CT colonograph has gained a lot of improvement. Based on all the published clinical trial results, the CT colonography for detection of polyp is much more accurate than barium anema and sigmoidoscopy. It also bears great potential for patient friendly examination comparing to the harsh colon

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    Finch, Tony Date: 02/26/2009
    Comment:

    With relatively low screening rates for CRC, this effective, patient-friendly screening test is desperately needed NOW. There are now too few gastroenterologists to do the job, and we are losing lives and dollars.

    It is well documented the VC is far more sensitive than other screening methods which are already covered by Medicare, such as flexible sigmoidoscopy and double contrast barium enema. [Imperiale, TF, et al. N Engl J Med2000;343:169-74], [Winawer SJ, et al. N Engl J Med

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    Patt, Richard Organization: RadMD
    Date: 02/26/2009
    Comment:

    I urge you to reconsider your potential coverage denial. Stepping backwards is no way to solve our health care woes. Take a bold and firm stance, pay for CTC screening, and relegate barium enemas for most patients to the history books. Richard Patt, MD

    DeMauro, Christopher Date: 02/26/2009
    Comment:

    There is strong research showing that CTC is a minimally invasive and cost effective method of detecting and staging colon cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]. Virtual Colonoscopy is more sensitive than other screening methods which are already covered by Medicare, such as flexible sigmoidoscopy and double contrast barium enema. [Imperiale, TF, et al. N Engl J

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    Mansour, Alfred Date: 02/26/2009
    Comment:

    Because of the rigorous scientific studies done CTC, ACRIN for one,It seems that this denial is ill advised. Pateints deserve this relatively non invasive option for colon cancer screening. Many people will skip screening for a highly curable disease,when detected early, because they are afraid of colonoscopy,but would undergo CTC. Early detection of Colon cancer will save lives and in the long run decrease expenditures on late stage disease.

    Privett, MD, George Title: Medical Director
    Organization: Lexington Diagnostic Center and OPEN MRI
    Date: 02/26/2009
    Comment:

    Screening CTC has been under development for several years and has been studied extensively as to sensitivity and specificity and cost effectiveness and patient acceptance. We have found it to be very useful as a screening tool for colon cancer. It has now been scientifically proved to be as accurate as traditional optical colonoscopy and better than sigmoidoscopy, air contrast barium enema and stool occult blood tests. Furthermore it costs 1/3 to 1/4 the price of optical

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    Gonzalez, Marcela Date: 02/26/2009
    Comment:

    Virtual colonoscopy is a basic care that should be covered for all human beings. A regular colonscopy not only is it invasive but carries high risk of colon tissue rupture specially in elderly.Virtual Colonoscopy should be by Medicare and Medicaid.

    Hermanson, Karen Date: 02/26/2009
    Comment:

    Please reconsider your decision to not fund CT Colonography for colorectal cancer. It would save lives, is non-invasive and cost effective for not only colorectal cancer but for anomalous findings that may be visible outside the colon that may otherwise not be found. Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt,

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    BRUNTZ, BONI Date: 02/26/2009
    Comment:

    Virtual colonoscopy provides a screening tool that is important to patients of all ages in that it is a known fact that it takes 10 optical colons to have a positive finding. Optical colons see only about 80% of the inside of the colon as the scope does not have the ability to rotate side to side and see behind the folds in the colon. In addition, the risk of perforation is greater than explained and becomes a huge issue if you or a loved one has experienced a perforation which can be

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    Abbott, Maxwell Date: 02/26/2009
    Comment:

    CTC is a proven screening technique for colorectal cancer. Many individuals refuse sigmoidoscopy and colonoscopy, but are willing to accept CTC. These individuals remain unscreened resulting in unneccessary suffering, expense and death from later stage colorectal cancer.

    Roebke, Brent Date: 02/26/2009
    Comment:

    [PHI Redacted]. I believe early detection is the best way to cure this disease. I can''t believe that you want to use old technology in today''s day and age. Also it has been proven to be less expensive

    Freiberg, Glen Date: 02/26/2009
    Comment:

    This email is a request for appropriate reimbursement for computer tomography colonography. Published data support the test, but may not fully recognize the number of patients who would elect this screening having avoided the non-virtual method. The benefit of bringing in more patients to be screened that would otherwise not be screened needs to be calculated in this process and grant the less traumatic process the opportunity to catch more polyps and cancers that can be intercepted.

    Soll, Shea Date: 02/26/2009
    Comment:

    CMS'' coverage policies guide coverage policies for private insurance carriers also, so this policy decision will likely have tremendous impact on long term costs and health. CMS'' approval of CT Virtual Colonoscopy would likely increase screening at younger but appropriate ages thereby reducing cancer risk to patients and the long term treatment costs that could be the federal government''s obligation. President Obama states he wants to increase preventative healthcare as part of the

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    Barr, Dorothy Date: 02/26/2009
    Comment:

    I have heard from many neighbors, friends, and relatives that they would be willing to have a CTC, but have refused a colonoscopy. The state that the colonoscopy does not visualize the entire colon, but CTC does. It is a less invasive procedure and therefore, no possibility of perforating the colon. I strongly believe that the CTC will ensure that a greater percentage of the population has colorectal screening. This will reduce the incidence and associated costs of treating colon cancer. I

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    Soll, Edward Title: Physician
    Organization: Retired
    Date: 02/26/2009
    Comment:

    Now with CT Colonoscopy, patients have the availability of a great screening tool at a price that''s much lower for the government that optical colonoscopy. Moreover, there will be more people that can take advantage of this procedure and they will loose less time from work and not have the need for expensive sedation and associated monitoring. How in the world can this committee fail to see the benefit that has been so well documented by qualified researchers at world class institutions.

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    Kogan, James Date: 02/26/2009
    Comment:

    I find it hard to comprehend denying coverage for this safe and cost effective test that would save hundreds of thousands of lives. With relatively low screening rates for CRC, this effective, patient-friendly screening test is desperately needed. Colorectal cancer screening saves lives. Coverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical Colonoscopy

    Multiple studies have shown that Virtual Colonoscopy is an effective screening

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    Remedios, Peter Date: 02/26/2009
    Comment:

    This is a test which helps screen a lot of older individuals who would otherwise not undergo testing. The GI docs cannot scope everyone and quite a lot of patients fear that exam

    It is short sighted of the administration to deny a test that would help in early detection of potential cancers..

    I urge coverage of this test by CMS

    Swerdlow, Daniel Title: Assistant Professor of Radiology
    Organization: Georgetown University
    Date: 02/26/2009
    Comment:

    I believe the available data is more than adequate to allow reimbursement for CT Colonography. The evidence is certainly suffucuent at least postpone such a strongly worded denial. Given the high prevalence of colorectal cancer, the notoriously poor screening rate and the inadequate numbers of trained optical colonoscopists to screen a significantly higher portion of the eligiblle population, such a denial will cost thousands of lives. I believe the motivation is based more on the current

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    Bourdet, Larry Date: 02/26/2009
    Comment:

    Here are referenced reasons why ooverage for Virtual Colonoscopy screening should not be denied:

  • Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]
  • Colorectal cancer screening saves lives
  • Coverage of Virtual Colonoscopy will result in the screening of

    More

  • Horton, Karen Date: 02/26/2009
    Comment:

    I am outraged at the CMS decision. Clearly it is not based on facts.

    There is more than adequate literature supporting CTC as a viable colon cancer screening test. It is certainly much better than barium enema or sigmoidoscopy. How can CMS pay for a sigmoidoscopy which only visualizes less than 50% of the colon, and not pay for CTC?

    Miller, Asher Title: Mr.
    Organization: Personal Opinion
    Date: 02/26/2009
    Comment:

    Although the convenience of virtual colonoscopy is extremely high, CMS should not cover it for routine procedures at this time. A routine screening, that is one without bowel obstruction or some other medically necessary reason for performing VC, should not enlist the option of a procedure which is financially desirable for health care professionals and also more desirable, e.g. less invasive, for the patient if it carries the known and definite risk of causing fatal cancer while a safer

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    Chase, Peter Date: 02/26/2009
    Comment:

    I think that not covering CTC is a short sighted policy. It would seem like a good idea to limit expenditures. However, CTC is less expensive than the invasive colonoscopy that patients would otherwise be getting. In addition, any measures that could cause more people to get screened should be encouraged as it has been shown that screening saves lives. The technique itself has been proven in trials and real world experience.

    Multiple studies have shown that Virtual Colonoscopy

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    Summerton, Susan Title: MD
    Organization: Albert Einstein Medical Center
    Date: 02/26/2009
    Comment:

    As a radiologist who has been performing and reading barium enemas for over 15 years and CT colonography for over 4 years, I must emphatically state that it CT colonography is tolerated much better than a Barium Enema, and most people who have a barium enema refuse to have another while just about all patients who have had CT colonography seem very willing to repeat the study for screening purposes. Also, I am much more confident in my ability to detect as well as exclude the presence of

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    Diers, Jay Title: Director of Imaging
    Organization: Heartland Regional Medical Center
    Date: 02/26/2009
    Comment:

    1. Acsess to conventional colonoscopy is limited and more patients could take advantage of CT Colonography. This screening tool has the potential to save manyn lives. Thank You

    Zito, Kenneth Date: 02/26/2009
    Comment:

    It is unfortunate that CMS has chosen to ignore the multitude of studies that in fact support CTC as a viable option for screening the thousands of medicare eligible beneficiaries who currently refuse to have an optical colonoscopy. The result is that we do not adequately screen for colon cancer.

    Fisher, Rosemary Title: Clinical Application Specialist
    Organization: FiatLux Imaging
    Date: 02/26/2009
    Comment:

    I believe that the CTC is vital for this aging population. The potential is there for an increased number of people to actually go through cancer screening if they have an alternative to the optical colonoscopy. One advantage that the virtual colonscopy test carries is there is no need for the conscious sedation protocol that most centers use when performing the optical test. This is a definite advantage to older patients, not having to give them any drugs that carry risk in and of

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    Sands, Michael Title: Imaging Manager
    Organization: DuBois Regional Medical Center
    Date: 02/26/2009
    Comment:

    I strongly urge CMS to approve screening CTC studies for the reasons outlined below:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]

    Colorectal cancer screening saves lives

    Coverage of Virtual Colonoscopy will result in the screening of patients who

    More

    ALVAREZ, CARLOS Date: 02/26/2009
    Comment:

    please reimburse for vc it will save the goverment money and save lives at the same time. many people do not get a colonscopy because of the risks and work involved. vc is the future.

    Thank you, Carlos Alvarez

    andersen, garrett Date: 02/26/2009
    Comment:

    Multiple studies have shown that Virtual Colonoscopy is an effective screening strategy for colorectal cancer. [Johnson CD, et al. N Engl J Med 2008;359:1207-17], [Kim, DH, et al. N Engl J Med 2007;357:1403-12], [Pickhardt, PJ, et al. N Engl J Med 2003;349:2191-200]Colorectal cancer screening saves livesCoverage of Virtual Colonoscopy will result in the screening of patients who are resistant to Optical ColonoscopyVirtual Colonoscopy is more sensitive than other screening methods which are

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    wilson, anna ludwig Date: 02/26/2009
    Comment:

    I am writing to ask that Medicare and Medicaid reimburse for physician requested and prescribed “Virtual Colonoscopy”. “Virtual Colonoscopy” using CT and CAD is less than half the cost of physical Colonoscopy, no insertion, same prep, no anesthesia, five minutes and you are pre-screened. This can be part of enormous savings to individuals, using un-invasive measures that are also of no health risk to the patient.

    Harrison, Bo Date: 02/26/2009
    Comment:

    I''ve recently learned of Medicare''s decision to deny coverage of the use of CTC as a tool for pre-screening for colorectal cancer, and am writing to express my strong concern, and my hope that this decision will be re-considered and reversed. There is abundant evidence that CTC is effective in detecting colorectal polyp growth, and the procedure is much cheaper, less invasive, and more readily accessible than traditional colonoscopy. By denying CTC coverage, and requiring the single

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    Nathenas Bubany, Viki Title: Managing Director
    Organization: MRI Associates of Queens, P.C.
    Date: 02/26/2009
    Comment:

    As an imaging center with a 64-slice CT, we do not perform Virtual Colonscopies at this time nor do we have the software. However, we are very surprised at the high number of inquiries we receive regularly regarding the Virtual Colonoscopy exam. The inquiries come mainly from middle to senior aged males, both walk-ins, but also patients and their families. We have received so many inquiries about the exam, particularly over the past few months, that we started to ask the reasons for the

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    Byrd, Linda Title: Digestive Disease Nurse Navigator
    Organization: Saint Joseph’s Hospital of Atlanta
    Date: 02/25/2009
    Comment:

    I am not quite sure how to address this email or even if I am sending it to the correct area within CMS,however, I feel it necessary to respond to the February decision that CMS made in regards to CT Colonography.I am the coordinator of the virtual colonoscopy program here at Saint Joseph’s Hospital in Atlanta. We started our program a year ago and are rapidly approaching out 100th procedure. I have had numerous phone calls from Medicare patients who just do not understand why our

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    Moss, Steven Title: President
    Organization: Northside Radiology Associates
    Date: 02/25/2009
    Comment:

    I am surprised that CMS would consider not covering CT colonography given the evidence that this is an effective screening tool. I think this test should be covered as it has been scientifically proven to be effective. Furthermore, it is much less invasive and provides much more information than other screening methods. All of these factors combined help to make this an excellent screening exam which is an important component of preventive medicine and early detection of disease which in

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    Norton, George Date: 02/25/2009
    Comment:

    Dear Medicare Official/Dear Senators Pryor and Lincoln/Dear Representatives Snyder and Ross:

    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer screening is the only way to prevent Colon Cancer. Many americans will not or cannot receive traditional colonoscopy as a screening test. Please do the right thing for seniors, and all Americans age 50 and

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    Hayat, Malik Date: 02/25/2009
    Comment:

    [PHI Redacted] I have also followed the development and growth of CTC for the past 10 years and firmly believe in the efficacy of this procedure. It is a cost effective procedure that has saved lives.

    It was a shock when I read the recent decision by Medicare denying its recipients CTC for colon cancer screening. After reading the 21 page decision, I was surprised to note that several important points were not even taken into account when making the decision. I

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    Phelps, Mark Title: MD
    Organization: private practice, family medicine
    Date: 02/24/2009
    Comment:

    A decision to deny coverage for CTC is a terrible medical as well as business decision. CTC is utterly risk-free, while colonoscopy carries the real risks of colon damage and anesthesia accident. CTC is offered at 1/2 to 1/5 the cost, and since all payors are obliged to pay for some form of diagnostic screening,if those people who are likely to need biopsies are directed away from CTC initially, the vast majority of CTC screens wiil be safe, cheap, and all that''s needed. The insinuation

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    Lim, Phil Date: 02/24/2009
    Comment:

    I strongly believe that screening CT colonography should be covered by Medicare. This test has undergone a multicenter clinical trial and has been proven to be as effective as optical colonoscopy .

    I have personally seen too many persons die from metastatic colon cancer, which is easily preventable by a screening test. This effective screening test should help reduce unnecessary expense for future treatment of colorectal cancer.

    Warson, James Title: physician
    Date: 02/24/2009
    Comment:

    I protest the CMS decision. Colorectal cancer advances have been made through early detection. Especially poorf and minority patients do not access the present diagnostic system until late in their disease. They are more likely to be diagnosed and treated early if CTC is available, since no prep, anesthesia, or instrumentation is involved. The cost overall is less with early detection and treatment. This is an accurate method with less fuss and more information. To deny it to the population

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    Kittredge, Roger Date: 02/24/2009
    Comment:

    I find it hard to believe that the decision is about to be made to deny this procedure as a covered benefit. The science behind this technology has been proven and the nature of the procedure can''t help but increase the number of people who have this important screening completed. This option will save lives that are currently being lost because of the fear that people have concerning the current singular screening method.

    It begs the question of the possibility that the intent

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    Tryhus, Michael Date: 02/24/2009
    Comment:

    Colon cancer kills 56,000 people in the US every year. This is regrettable since over 90% arise from an adenomatous polyp the target for CTC . Only 30% of patients of average risk over 50 are screened by optical colonoscopy (OC). CTC ''s aim is to fill the gap by providing a more widely available, less invasive and cost effective alternative. In centers where CTC screening has been deployed double the amount of patients have been screened. CTC has been validated with a multicenter

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    Dalton, Jean Date: 02/24/2009
    Comment:

    I am appalled at this decision in view of the support for this process by the professional organizations listed. At the very least, this should be considered for exceptions to coverage exclusions under the Americans with Disabilities Act for persons who have a history of extreme allergies and adverse reactions to chemicals, including the anesthetics and sedatives used normally for a colonoscopy (as well as the risks for such persons of general anesthesia when the milder forms are

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    sclafani, salvatore Date: 02/23/2009
    Comment:

    The value of CT colonography is clear from the literature showing substantive similarity to optical colonography at less risk to patients. With the ADDED values of detection of aortic aneurysm and other pathology, it is difficult to understand CMS opinion. This clearly reduces faith in governmental ability to lead evidence based medicine. What exactly is the agenda of CMS in denying this procedure its place? Ludditeism? politics? money?

    I am very dissatisfied with this decision.

    Lobdell, Ph.D., CHP, John Organization: retired
    Date: 02/23/2009
    Comment:

    February 23, 2009

    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. Colon Cancer is a major concern to all Americans age 50 and older. Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined. Appropriate screening is the only way to prevent Colon Cancer. If detected at any early stage, it is easily correctable.

    The discussion that was a part of the Decision Memo indicated that the screening

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    Kapushinski, Tiffany Date: 02/23/2009
    Comment:

    Please support this screening!! It may save lives!

    Merten, Charles Date: 02/23/2009
    Comment:

    Virtual Colonoscopy is, in today''s econonomy, now the only cost-effective technique to use. The proposed rule excluding it is contrary to the public good, and certainly contrail to the public purse. A large percentage of the Congress is chomping at the bit to reduce medicare and medicade costs by reducing the number of participants. Your office must seize every opportunity to replace existing testing and treatment modalities by equally effective but less costly methods.

    Thomas, Deborah Date: 02/23/2009
    Comment:

    I cannot believe what I just read on this matter.......shame on you.

    douglas, landers Title: Radiologist
    Organization: Innovis Health
    Date: 02/23/2009
    Comment:

    As a Radiologist I find it difficult to understand the logic behind not reimbursing for CTC when several studies have shown it to be superior to barium enema which is reimbursed. We have the potential to screen a large number of individuals at risk who avoid colonoscopy for various reasons. Please reconsider. Thanks.

    bartow, john Title: Director of Imaging
    Organization: The Doctors Clinic a Multispecialty Group
    Date: 02/23/2009
    Comment:

    [PHI Redacted] Therefore, I am saddened that there is resistance to a developed examination that cost considerably less, needs no sedation, has few if any complications, ie perforation and hemoraging, and allows a participant to get immediately back to work after a 20 minute exam. Colonoscopist are important and do a great job of looking and removing or biopsing lesions, but the expense, the miss rate due to limitations in their examination, and the complication that arise

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    Kerestes, Al Date: 02/23/2009
    Comment:

    Your decision to restrict reimbursement for CTC makes no sense. Significant portions of the population currently go unscreened due to difficulties with optical colonoscopy. Why would you not approve a procedure that costs less, is less invasive, does not require sedation and has no risk potential. You guys/gals amaze me!!!

    Blair, Robert Date: 02/23/2009
    Comment:

    I support Medicare coverage for the virtual colonoscopy procedure....

    ROSENFELD, BETTY Date: 02/23/2009
    Comment:

    WE NEED ALL THE HELP THAT WE CAN GET TO HAVE PEOPLE SCREENED FOR COLON CANCER. ALL INSURANCE COMPANIES SHOULD PAY FOR THIS. IT IS FAR LESS EXPENSIVE THAN THE TREATMENT FOR COLON CANCER.

    Petrella, Edward Date: 02/22/2009
    Comment:

    Screening CT colonography provided it is limited to 64 slice or above scanners is an effective took in discovering polyps and colon Carcinoma. Data is contaminated by the inclusion of lesser scanners.

    The benefit to patients is that ct colonoagraphy does not require anesthesia, taking days off from work, an individual to accompany the patient. It''s accuracy when using 64 slice or better scanners is well documented,

    It''s downside is the need for a theurapeutic

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    Riach, John Date: 02/22/2009
    Comment:

    i encourage cms to support virtual colonoscopy because it will save thousands if not tens of thousands of lives. moreover, it will be far less costly and invasive (and safer) than conventional optical procedures which require an intravenous sedation or general anesthetic. thank you

    Coughlin, Bret Title: MD
    Date: 02/22/2009
    Comment:

    I have been practicing diagnostic radiology for close to 20 years and am well aware of how rapidly the use of imaging has expanded and with it the associated costs. I understand the difficulty in approving new expensive techniques which will undoubtedly have initial increased costs.

    However, I am struck by how different CT colonography or "virtual colonoscopy" is. The test is generally better tolerated and more acceptable to patients who often decline colonoscopy rather than submit to

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    Reichheld, James Organization: Digestive Health Specialists, PC
    Date: 02/22/2009
    Comment:

    I am dismayed that CT Colonography (CTC) continues to be considered as a viable screening test for routine CRCA screening. It is precisely the medicare population that has a high polyp rate. Further, it is only after disregarding polyps smaller than around 5 mm - not even reporting them - that CTC becomes remotely appropriate from an economic perspective. However, assuming these polyps are not of clinical consequence is a critical error and clinically inappropriate. All adenomatous

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    Chacko, Anna Date: 02/22/2009
    Comment:

    The dangers of Optical colonoscopy have not been addressed - the percentage of perforations and other complications are very real. Furthermore, patients having other co-morbidities such as prior surgeries, adhesions from surgeries,or inflammatory processes should not be subjected UNNECESSARILY to the very real dangers of colonoscopy. This is really about a turf war rather than something that would benefit patients. [PHI Redacted]

    Oman, Patricia Date: 02/21/2009
    Comment:

    Have you ever had one of these invasive tests??? I cannot think why you would even slightly consider funding only the invasive procedure - there is no logic to that thinking at all! [PHI Redacted] Please do not eliminate funding for the Tomography Colonography!

    Plymale, Jennifer Title: Director
    Organization: Robert C. Byrd Center for Rural Health
    Date: 02/20/2009
    Comment:

    February 20, 2009

    Re: Screening Computed Tomography Colonography (CTC) for Colorectal Cancer

    From: Jennifer T. Plymale, Assistant Dean, Director, Robert C. Byrd Center for Rural Health
    Joan C. Edwards School of Medicine, Marshall University

    Colon cancer is the second leading cause of cancer death in men and the third leading cause of cancer death in women in West Virginia. Recent reports indicate that more than 1,300 new cases of colon and rectal cancer are diagnosed

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    Schneider, Steven Title: Radiologist
    Date: 02/20/2009
    Comment:

    It is disappointing that CMS has decided not to approve payment for Virtual Colonoscopy as a cancer screening tool. The recent data demonstrates that CTC is as accurate as colonoscopy, if not more so, and the test has less complications. It is also less time-consuming, less uncomfortable, and less expensive.

    It is time CMS stops regarding money as the overwhelming issue and consider the care of their clients, the people of the USA. Not approving CTC will lead to more colon

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    Moorey, Robert Date: 02/20/2009
    Comment:

    I believe that the virtual screening exam for cancer in the colon to be the easiest, quickest and most effective in reducing the numbers of deaths due to this disease. Please revisit the approval of this state-of-the-art procedure. Thank you.

    Curtis, John Title: MD
    Date: 02/20/2009
    Comment:

    Dear Medicare Official
    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

    Why did Medicare not acknowledge that more than 50% of Americans have not, will not, or cannot receive

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    Smith, Willis Date: 02/20/2009
    Comment:

    Dear Medicare Official:

    I am writing to voice my objection with Medicare''s recent denial of coverage for Virtual Colonoscopy. I am aware that Colon Cancer touches all Americans and is a major concern for all Americans age 50 and older. Colon Cancer kills more Americans each year than Breast Cancer and Aids combined. Appropriate screening is the only way to prevent Colon Cancer.

    Why did Medicare not acknowledge that more than 50% of Americans have not, will not or cannot receive

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    Hill, Gloria N. Date: 02/19/2009
    Comment:

    SUBJECT: Pending Decision on Virtual Colonoscopies

    TO: Center for Medicare and Medicaid Services

    ATTN: Steve E. Phurrough, Director
    Coverage and Analysis Group
    7500 Security Blvd
    Baltimore MD 21244-1850

    20 Feb 2009

    Reference Medicare's recently stated intent not to pay for Virtual Colonoscopies. I do not believe there are any federal government employees qualified to make medical decisions.

    [PHI

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    Sylva, Larry Title: Endodontist
    Date: 02/19/2009
    Comment:

    I am writing to voice my objection to the recent denial of coverage for Virtual Colonoscopy. I am aware that colon cancer is a major concern to all Americans age 50 or older& that Colon cancer kills more Americans each year than breast cancer & AIDS combined & that appropriate screening is the only way to detect & prevent colon cancer. Why did Medicare not acknowledge that more than 50% of Americans have not, will not or cannot receive traditional colonoscopy as a screnning

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    Veach, Casey Title: Radiologist
    Organization: Advanced Radiology, S.C.
    Date: 02/19/2009
    Comment:

    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. We are all aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.As radiologists who have reviewed the literature, we are shocked by the conclusion. Large, randomized, and blinded studies have been

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    Tillman, Craig Title: Physician/Radiologist
    Organization: Advanced Radiology, S.C.
    Date: 02/19/2009
    Comment:

    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. We are all aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.As radiologists who have reviewed the literature, we are shocked by the conclusion. Large, randomized, and blinded studies have been

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    Swanson, John Organization: Advanced Radiology, S.C.
    Date: 02/19/2009
    Comment:

    I am writing to voice my strong disagreement with Medicare''''s recent denial of coverage for Virtual Colonoscopy. We are all aware that Colon Cancer is a major concern to all American''''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.

    As radiologists who have reviewed the literature, we are shocked by the conclusion. Large, randomized, and blinded

    More

    Schroeder, Reid Title: Radiologist
    Organization: Advanced Radiology, S.C.
    Date: 02/19/2009
    Comment:

    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. We are all aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.As radiologists who have reviewed the literature, we are shocked by the conclusion. Large, randomized, and blinded studies have been

    More

    Rhee, Yang Title: Radiologist
    Organization: Advanced Radiology, S.C.
    Date: 02/19/2009
    Comment:

    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. We are all aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.As radiologists who have reviewed the literature, we are shocked by the conclusion. Large, randomized, and blinded studies have been

    More

    Patramanis, George Title: Physician/Radiologist
    Organization: Advanced Radiology, S.C.
    Date: 02/19/2009
    Comment:

    I am writing to voice my strong disagreement with Medicare''s recent denial of coverage for Virtual Colonoscopy. We are all aware that Colon Cancer is a major concern to all American''s age 50 and older, that Colon Cancer kills more Americans each year than Breast Cancer and AIDS combined, and that appropriate screening is the only way to prevent Colon Cancer.As radiologists who have reviewed the literature, we are shocked by the conclusion. Large, randomized, and blinded studies have been

    More

    Patel, Pranav Title: Physician-Radiologist
    Organization: Advanced Radiology, S.C.
    Date: 02/19/2009
    Comment: