WASHINGTON, D.C. – Today, U.S. Sens. Ben Cardin (D-MD), Sherrod Brown (D-OH), Roger Wicker (R-MS), and Susan Collins (R-ME) reintroduced legislation to protect seniors from out-of-pocket costs for preventive colonoscopies.
Currently, Medicare charges seniors for colonoscopies when a polyp is removed during the procedure even though colorectal cancer screenings are promoted as a free service under Medicare. The Removing Barriers to Colorectal Cancer Screening Act would make a long-overdue fix to Medicare to ensure seniors aren’t charged for a colonoscopy – regardless of whether or not a polyp or tissue is removed. Removing harmful tissue during these procedures is key to preventing cancer, yet the fear of having to pay unexpectedly could prevent Medicare recipients from getting these important screenings.
“Colonoscopies save lives. We need to ensure that more Americans opt for this highly effective method of colorectal cancer screening, without worrying about unexpected costs,” said Cardin. “We promote quality preventive care precisely because it allows for the discovery of problems in early stages, which saves lives and money. I am proud to work with a bipartisan group of Senators to fix an obvious flaw in our Medicare system.”
“Seniors shouldn’t be punished for undergoing a potentially lifesaving procedure,” said Brown. “These preventive life-saving screenings should be available to seniors at no out-of-pocket cost, especially when a doctor makes the decision to remove a potentially harmful polyp.”
“This legislation would provide a much-needed fix to current Medicare policy regarding colonoscopies,” Wicker said. “Most colorectal cancer is preventable, making these screenings vital to saving lives. Seniors should not have to worry about the threat of unexpected medical costs when considering whether to pursue this effective preventive care.”
“Colorectal cancer is one of the leading causes of cancer deaths, yet it is one of the few cancers that can be completely prevented with proper screening. These life-saving tests should be available to all Americans,” said Senator Collins. “By removing the financial barriers to colonoscopies, this bipartisan bill would prevent more cases of colorectal cancer, improve health, and save lives.”
Colonoscopies allow for the detection and removal of polyps that could become cancerous, as well as for the early detection of colorectal cancer when treatment can be most effective. Under current law, seniors covered by Medicare are eligible for colorectal cancer screenings without out-of-pocket costs. However, if a physician takes a further preventive action – like removing a polyp – during the screening while the patient is under anesthesia, the patient is billed as if the procedure was treatment rather than prevention.
Because there is no way of knowing whether a polyp will be removed during a screening colonoscopy in advance, Medicare beneficiaries do not know whether or not their screening colonoscopy will be fully covered until after the procedure is over. This potential cost could lead to Medicare beneficiaries electing to forgo this important preventive screening, even though colorectal cancer screening is promoted as a service without cost-sharing under Medicare. Private insurers cannot impose cost-sharing for a screening that leads to polyp removal, but Medicare can charge fees if a polyp is removed. The Removing Barriers to Colorectal Cancer Screening Act would correct this discrepancy by waiving cost-sharing under Medicare for preventive colonoscopies, even if a polyp or tissue is removed.
Colorectal cancer is the second leading cause of cancer death in the United States for both men and women combined. However, when caught early, it is curable and can even be prevented.