As a board-certified dermatologist, I regularly treat patients with the most common cancer in the U.S., nonmelanoma skin cancer, affecting 3.3 million Americans yearly, including roughly 68,000 in our state. There are two primary treatment options, but one, an FDA-cleared, Medicare-covered nonsurgical option, is under threat from self-interested parties.
We’re all at risk for this type of cancer. The primary cause is exposure to the sun’s UVA rays, which penetrate clouds and windows, and reflect off water and sand. At higher risk are older adults, those with a family history of skin cancer, those with lighter skin, red or blond hair, moles, or a weakened immune system.
The traditional treatment has been Mohs surgery, where the doctor cuts away suspect tissue until microscopic examination of the sample shows no cancer cells remaining. Recently, a nonsurgical alternative with the same 99%+ cure rate but no cutting, surgical scarring or need for reconstructive surgery has become available. It’s called Image-Guided SRT or the GentleCure Experience and it uses low-level x-rays, precisely targeted with ultrasound imaging.
With this, the dermatologist can provide cancer center-level care in their private practice, with Medicare and most insurance companies providing reimbursement.
But that could change. Palmetto GBA, a Columbia, SC, company, that sets regional Medicare policy, wants to cancel coverage of Image-Guided SRT in SC and six other states.
Cancelling coverage will not save Medicare a dime, and patients would be forced to undergo surgery, or not treat their cancer at all.
There is no medical or economic rationale for eliminating reimbursement for this proven treatment. Depriving patients of this gold standard of nonsurgical treatment for nonmelanoma skin cancer would only benefit a small number of hospital-based physicians while enriching private insurance companies.
Palmetto should leave coverage of Image-Guided SRT alone, and leave patients a treatment choice.
Dina V. Hunter, M.D.
dinahunter@skinmdsc.com
The Dermatology Group
1709 Barnwell St.
Columbia, SC 29201
803-254-3376
