Medicare Coverage Is Threatened for the 65,000 Alabamans Likely to Get Skin Cancer this Year

CHICAGO, April 2, 2024 /PRNewswire/ -- According to the Dermatology Association of Radiation Therapy (DART), some 65,000 Alabamans are likely to be diagnosed with a common form of skin cancer this year, but for those covered by Medicare, reimbursement for a nonsurgical treatment offered by dermatologists may be stripped away.

Palmetto GBA, a subsidiary of Blue Cross and Blue Shield of South Carolina, is authorized by the federal government to regulate Medicare in Alabama and six other states. Palmetto is moving quickly to cancel coverage, which has been in effect nearly 10 years. That would leave coverage only for procedures at radiation therapy cancer centers or for Mohs surgery in most cases, although Mohs surgeons are relatively few in number and are rarely found in rural communities.

Nonmelanoma skin cancer (basal cell and squamous cell carcinoma) is the most common type of cancer in the U.S., affecting some 9,500 Americans every day, with more than 3.3 million new cases recorded yearly nationwide.

Until recent years, Mohs surgery was the usual treatment, with the doctor cutting away suspect tissue, examining each sample under a microscope, and continuing until the resected tissue appeared free of cancer cells. Pain, surgical scarring and the need for reconstructive surgery were not uncommon effects of the treatment.

Then, in 2015, a safe, noninvasive, FDA-cleared treatment option with no surgical scarring began being offered in dermatology practices. Dermatologists achieved the same 99%+ cure rate as Mohs surgery with the newer Image-Guided Superficial Radiation Therapy, also called Image-Guided SRT, or IGSRT. The scientifically proven treatment, that uses low-level x-rays guided by ultrasound imaging, won favor with patients and dermatologists. Medicare and most private insurance plans covered the procedure.

"The insurance industry group that controls Alabama's Medicare coverage is clearly ill-suited to render judgment on Image-Guided SRT," said Jacob Scott, MD, DPhil., president of the Dermatology Association of Radiation Therapy (DART). "No experts in the use of, or research related to Image-Guided SRT were invited to participate in panels to discuss the technology, nor have they been contacted by Palmetto for input into policy formation. In their first hearing, the scientific literature they considered was published before this newer treatment even existed."

Dr. Michael Digby of Renew Family Dermatology in Fort Payne, noted, "Patients deserve to be fully informed of their treatment options, and Medicare and private carriers should cover Image-Guided SRT whenever patient and doctor determine it is the most appropriate therapy. For some patients, Mohs surgery is not even recommended – for example if they have diabetes or are immunocompromised – and there are many individuals who are fearful of surgery or do not want surgery and deserve to have a nonsurgical option. Image-Guided SRT is a valuable and necessary treatment option that must continue to be covered by Medicare."

Consumers who care about keeping their insurance coverage for the nonsurgical treatment should write to the panel by May 11, at [email protected].

Media Contact:
Matt Russell
Russell Public Communications
520-232-9840
[email protected] 

SOURCE Dermatology Association of Radiation Therapy