Proposed Legislation Protects Beneficiaries from Charges after Receiving Colon Cancer Screening
This month, Senator Sherrod Brown (OH) proposed legislation to protect older Americans receiving colon cancer screenings from “unfair” costs when their screening becomes diagnostic. The Removing Barriers to Colorectal Cancer Screening Act aims to improve the preventive care landscape by ensuring that colon cancer screenings that become diagnostic remain cost free. Medicare covers colon cancer screenings as preventive care as well as annual mammograms, heart disease screenings, flu shots, and others. Thanks to the Affordable Care Act (ACA), most preventive care is covered without cost sharing for people with Medicare; however, if a preventive screening (like a colonoscopy) requires a physician to intervene, the screening becomes diagnostic and the beneficiary must pay a copay or coinsurance for both the screening and the intervention.
The best example of a free colon cancer screening becoming diagnostic is when a polyp is discovered and removed during a preventive colonoscopy. In many cases, removing a cancerous polyp prevents colon cancer from forming or spreading. When a polyp is removed, the patient is charged cost sharing for procedure to remove the polyp. If no polyp is removed, the very same screening would otherwise be free of cost sharing.
Senator Brown believes that this discrepancy discourages Medicare beneficiaries from following through with preventive colon cancer screenings, which could have catastrophic consequences. “Colorectal cancer is the third leading cause of cancer death in the country,” Brown said. “But too many seniors who go in expecting a free, preventive screening, wake up to an unexpected and significant bill.” The senator went on to say that over 60 percent of colon cancer deaths could be prevented through colonoscopies and other colorectal cancer screening measures. He hopes this new legislation encourages people with Medicare to seek out preventive colon cancer screenings.