WASHINGTON, D.C. – U.S. Sens. Sherrod Brown (D-OH), Roger Wicker (R-MS), Ben Cardin (D-MD), and Susan Collins (R-ME) introduced 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.
“Let’s face it – colonoscopies are already unpleasant. We shouldn’t make matters worse by charging seniors for what’s supposed to be free under Medicare,” said Brown. “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.”
“Seniors should have peace of mind that their colorectal cancer screenings are not going to be followed by unexpected medical costs,” Wicker said. “Most colorectal cancer is preventable, making these screenings vital to saving lives. This legislation is a sensible way to streamline preventive care for Medicare beneficiaries and can reduce costs in the long run.”
“We know the life- and cost-saving benefits of ensuring Americans have access to quality preventive health care,” said Cardin, a member of the Senate Finance Health Care Subcommittee. “Colonoscopies save lives, and I am proud to join with a bipartisan group of Senators to fix an obvious flaw in our Medicare system. We want more Americans to opt for this highly effective method of colorectal cancer prevention, without worrying about unexpected costs.”
“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. We must work to ensure that all Americans have access to these life-saving tests,” said Collins. “By removing the financial barriers to colonoscopies, we can 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.