CMS Proposes Covering Pap Smear/HPV Testing For Cervical Cancer

AAFP's Proactive Stance Pays Off for Patients

April 29, 2015 09:06 am Sheri Porter

A little more than a year ago, the AAFP prodded CMS(2 page PDF) to update its coverage of screening for cervical cancer for women ages 30 to 65. The AAFP noted at the time that CMS had the authority to add additional preventive services to Medicare coverage.

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Fast forward 12 months and it's obvious that the Academy's persistence -- along with its knowledge of Medicare rules and regulations -- paid off.

CMS Recommendation

CMS recently issued a proposed decision memo( regarding screening for cervical cancer; specifically, the agency proposed covering HPV testing -- in conjunction with a Pap smear test -- once every five years for asymptomatic Medicare beneficiaries 30 to 65 years old who wish to extend the screening interval.

According to CMS, "evidence is sufficient" to add HPV testing as an additional preventive benefit and Medicare will cover screening for cervical cancer with the appropriate FDA-approved lab tests.

CMS' proposal not only represents a win for patients and their families, but affirms the AAFP's wisdom in fighting for the inclusion of HPV testing in screening for cervical cancer in certain cases. After all, HPV is associated with most cases of cervical cancer, a point the AAFP made clear in its communication with the agency.

Story Highlights
  • CMS recently proposed an additional preventive benefit to Medicare beneficiaries regarding cervical cancer screening for women ages 30 to 65.
  • CMS will allow asymptomatic women the option of screening once every five years with HPV testing in conjunction with a Pap smear.
  • The agency's action came at the behest of the AAFP in the form of an official request to CMS in 2014 to initiate a national coverage analysis for cervical cancer screening.

AAFP Board Chair Reid Blackwelder, M.D., of Kingsport, Tenn., was pleased with the agency's action. "CMS has made this requested change in a critical aspect of providing health care and screening for preventable disease in women," he told AAFP News.

"In addition, CMS specifically recognized the evidence-based advocacy the AAFP consistently implements for our patients," said Blackwelder. "We have worked hard to be at the table where regulatory decisions that impact patients are being made. This decision is affirmation of the changes the AAFP can help direct.

"We look forward to more collaboration with CMS on similar issues," he added.

Timeline of AAFP Actions

In an April 24, 2014, letter to CMS Chief Medical Officer Patrick Conway, M.D., (then) AAFP Board Chair Jeff Cain, M.D., of Denver, noted that the approval of screening with a combination of Pap smear and HPV testing every five years would make Medicare coverage "consistent with the clinical recommendations of the U.S. Preventive Services Task Force (USPSTF) and AAFP."

The AAFP recommends cervical cancer screening with Pap smear every three years in women ages 21-65 or with a combination of Pap smear and HPV testing every five years for women ages 30-65 who choose a longer screening interval.

The AAFP recommends against cervical cancer screening with HPV testing alone or in combination with a Pap smear in women younger than age 30; USPSTF guidelines( mirror those of the AAFP.

Blackwelder took up the torch in December 2014 with a second letter(2 page PDF) to Conway applauding CMS for accepting the Academy's formal request to initiate a national coverage analysis on the issue.

Blackwelder urged CMS to "promptly implement policy consistent with the recommendations of the USPSTF and the AAFP."

On page four of CMS' current proposal, the agency recognized the AAFP's due diligence on the matter, affirmed that it had received a formal request for a national coverage determination from the AAFP and included the AAFP's letter on the tracking sheet( maintained on the CMS website.

CMS is currently seeking comments on the proposed decision( and will respond to any comments it receives in its final decision memorandum.

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