Medicare To Cover Treatment For Sun-Induced Skin Lesions

The Centers for Medicare and Medicaid Services (CMS) announced July 20, 2001 that it will expand Medicare coverage nationally for the treatment of common sun-induced skin lesions, known as actinic keratoses, that can develop into skin cancer.

The decision establishes a national Medicare coverage policy for removing the lesions without restrictions based on lesion or patient characteristics. Previously, some Medicare claims-processing contractors had established local policies that restricted coverage to specific lesion types (such as those located on specific parts of the body) or in certain patients (such as those with a prior history of skin cancer).

"This decision will enable all Medicare beneficiaries to get these lesions removed before they can develop into cancer," HHS Secretary Tommy G. Thompson said. "It makes sense for Medicare to provide uniform coverage nationally for proven treatments that prevent deadly disease."

Actinic keratoses are common in fair-skinned individuals with a significant history of sun exposure. The risks of developing the lesions increase with advancing age. Studies indicate that as much as 60 percent of the population will develop the condition at some point during their lifetime.

"This is an especially important decision because this condition affects so many of our beneficiaries," CMS Administrator Thomas A. Scully said. "It is another important step toward ensuring that Medicare responds to the needs of the people it serves."

The most common treatment for actinic keratoses is removal with liquid nitrogen. Other common treatments include surgical removal and topical treatments using special creams.

After a review of the scientific and clinical evidence, CMS, formerly the Health Care Financing Administration, determined that the evidence regarding actinic keratoses is sufficient to provide uniform Medicare coverage to have them removed. More information on the national coverage decision is available at http://www.hcfa.gov/coverage/8b3-t.htm.