Medicare Suspends Penalty-for-PSA-Testing Proposal

Nick Mulcahy

March 28, 2016

The Centers for Medicare & Medicaid Services (CMS) has "temporarily suspended development" of a proposal that would have penalized physicians for performing "nonrecommended" prostate cancer screening with the prostate-specific antigen (PSA) test, the agency said last week.

However, the idea of Medicare establishing parameters for PSA testing has not been completely abandoned.

In an online statement, CMS said it will continue to solicit input "to determine whether a restructured, appropriate-use PSA measure should be developed."

Appropriate use of PSA testing is being investigated to "address overuse and patient safety," according to CMS.

The announcement has been expected since early March, when it was reported by Medscape Medical News that a key advisory group to Medicare intended to recommend that CMS not consider further recommendation of the PSA penalty idea.

In the now-suspended proposal, nonrecommended PSA testing was defined in accordance with guidance from the US Preventive Services Task Force, and referred to routine use of the test for prostate cancer screening in otherwise healthy men of all ages.

PSA testing for diagnostic or surveillance purposes was exempt from the proposal.

Earlier this month, two experts expressed satisfaction that the proposal was to be shelved.

"I am very relieved to hear that this proposed policy was reversed," said Stacy Loeb, MD, a urologist at New York University in New York City, in an email to Medscape Medical News. The proposal would have "not allowed patients to make informed choices about their own healthcare," she said.

"I am certainly glad cooler heads prevailed," said Alexander Kutikov, MD, a urologic oncologist at the Fox Chase Cancer Center in Philadelphia.

He called the proposal to penalize doctors for using the PSA test "rather Draconian." Dr Kutikov also told Medscape Medical News at that time that the American Urological Association (AUA) was working with CMS "to structure a more measured policy change."

In early March, the AUA touted its effectiveness in a statement, saying that it "responded swiftly and strongly" to the proposal, organizing public review and comment on the measure.

"This is a perfect example of how strong we can be when we all work together and speak loudly with one voice," David F. Penson, MD, a urologist at Vanderbilt University in Nashville, Tennessee, who is chair of the AUA Public Policy Council, said in the statement. "Essentially, our galvanized response to these threats to PSA helped stop these measures from moving forward without input from urologists and patients."

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