This month, CHEST Podcast Editor D. Kyle Hogarth, MD, FCCP, presents a special topic podcast on the recent vote of the Centers for Medicare and Medicaid Services (CMS) national coverage determination panel that there is not enough evidence to warrant Medicare coverage of low-dose CT screening for lung cancer. He is joined in conversation by Frank C. Detterbeck, MD, FCCP (Yale University), Scott Manaker, MD, PhD, FCCP (University of Pennyslvania), and David F. Yankelevitz, MD (Mount Sinai Hospital). They address some of the factors that went into the decision. Drs. Detterbeck, Manaker, and Yankelevitz also provide their interpretations of the important National Lung Screening Trial (NLST) and the results of studies from the International Early Lung Cancer Action Program (I-ELCAP), a multicenter clinical study in which patients were screened with CT using a common protocol.