WASHINGTON — U.S. Senator Ben Cardin (D-Md.), a member of the Senate Committee on Finance Health Care Subcommittee, recently introduced a measure to help prevent colorectal cancer, which has become the second leading cause of U.S. cancer deaths. Senator Cardin’s legislation, S. 1079, the Supporting Colorectal Examination and Education Now Act of 2015, promotes access to colorectal cancer screening. Known as the “SCREEN Act,” the measure includes several important improvements on existing policy. Congressman Richard E. Neal (D-Mass.) has introduced a companion measure, H.R. 2035, in the House of Representatives.
“We know that preventive health care saves lives and costs. And we know that early detection and intervention through screenings are key to preventing colorectal cancer. The SCREEN Act reflects that knowledge, removing financial barriers to both screening colonoscopies and follow-up colonoscopies needed after a positive finding from another test,” said Senator Cardin. “The act ensures that our seniors are able to take full advantage of these potentially life-saving procedures.”
A central provision of the SCREEN Act would waive cost-sharing under Medicare for all screening colonoscopies, even if a polyp or tissue is removed, as well as for follow-up colonoscopies needed to complete the “screening continuum” after a positive finding from another colorectal cancer screening test. Under current law, seniors covered by Medicare are eligible for colorectal cancer screenings without cost sharing. But if a physician takes further preventive action – like removing a polyp or tissue – during the screening colonoscopy, the procedure is billed as a treatment rather than a screening, and the patient is required to pay the coinsurance, which often amounts to hundreds of dollars.
Because it is impossible to know in advance if a polyp will be removed during a screening colonoscopy, Medicare beneficiaries do not know whether the procedure will be fully covered until it is over. This uncertainty and the financial barrier that coinsurance creates may result in Medicare beneficiaries not choosing this highly effective method of colorectal cancer prevention. Reducing disincentives for both screening colonoscopies and necessary follow-up colonoscopies will improve health outcomes and save money for both seniors and the Medicare program.
The SCREEN Act also seeks to improve coordination of care and promote other important age-based screening for Medicare beneficiaries, such as Hepatitis C screening, by creating a demonstration project. The demonstration project would provide reimbursement for a pre-procedure office visit, allowing Medicare beneficiaries to sit down with their physicians and discuss the procedure and any questions or concerns they may have prior to the colonoscopy. This office visit also would provide an opportunity for doctors to educate Medicare beneficiaries about the importance of a one-time Hepatitis C screening, as recommended by the Centers for Disease Control and Prevention (CDC) and the U. S. Preventive Services Task Force (USPSTF).
Finally, the SCREEN Act would provide incentives for Medicare providers to participate in nationally recognized quality improvement registries to ensure that Medicare beneficiaries are receiving the quality screening they deserve.