March 29, 2016
Based on input received during a public comment period, the Centers for Medicare & Medicaid Services (CMS) has temporarily halted a proposed measure that would have penalized clinicians for performing non-recommended prostate-specific antigen (PSA) screening.
The proposal had been developed in accordance with guidance from the US Preventive Services Task Force, which recommends against routine PSA-based prostate cancer screening for health men, regardless of age. CMS intended to use this guidance as the basis of quality measure for appropriate use of PSA testing, with the goal of addressing “overuse and patient safety,” according to CMS.
When the measure was opened up for public comment from October to November 2015, CMS received 358 comments. Of the feedback received:
- Nearly 6 in 10 contained statements opposing limitations on PSA screening for the general male adult population.
- Nearly half (4 in 10) contained comments that disagreed with the United States Preventive Services Task Force guidelines that were used to draft the measure or with other evidence cited in the draft.
- More than one-third contained personal stories about patients’ experiences with prostate cancer or cancer screening.
Despite the temporary hold on the proposal, an appropriate use measure for PSA testing could eventually re-emerge in another form. In its statement, CMS noted that it “will continue to solicit input from multiple stakeholders, including specialty societies, to determine whether a re-structured appropriate use PSA measure should be developed.” A new proposed measure will be resubmitted for review if CMS deems it necessary.
“CMS will continue to evaluate appropriate use measure concepts to address overuse and patient safety on prostate cancer screening, as well as additional measure gap areas,” read the statement.