The Removing Barriers to Colorectal Cancer Screening Act of 2015 (H.R. 1220 / S. 624), sponsored by US Representative Charlie Dent (R-PA) and US Senator Sherrod Brown (OH), works to correct an oversight in current law that requires Medicare beneﬁciaries to cover the cost of their copayment for a “free” screening colonoscopy if a polyp is discovered and removed during the procedure.
According to the American Cancer Society, deaths from colorectal cancer have been declining for more than two decades, mostly because of screenings, including colonoscopies and other tests.
The United States Preventive Services Task Force guidelines call for individuals of average risk of colon cancer between the ages of 50 and 75 to be screened, but only about half in the US are screened as recommended.
According to the Centers for Disease Control and Prevention (CDC), colon cancer remains the leading cause of cancer death among nonsmokers. The CDC estimates that if all precancerous polyps were identiﬁed and removed before becoming cancerous, the number of new colorectal cancer cases could be reduced by 76 to 90 percent.
Under current law, Medicare waives coinsurance and deductibles for colonoscopies. When a polyp is discovered and removed, the procedure is reclassiﬁed as therapeutic for Medicare billing purposes and patients are required to pay the coinsurance. This bill would eliminate unexpected costs for Medicare beneﬁciaries when a polyp is discovered and removed, ensuring that unexpected copays do not deter a patient from having the screening performed.
By eliminating ﬁnancial barriers, this legislation would attain higher screening rates and reduce the incidence of colorectal cancer.
Currently, ASCs do not have a voice on the Advisory Panel on Hospital Outpatient Payment, which controls various aspects of physician payment rates. This legislation would add an ASC industry leader to that panel.
- The bill would also add transparency to the health care industry by requiring the Centers for Medicare and Medicaid Services (CMS) to disclose which criteria they use to deny certain procedures from being performed in an ASC and by requiring them to make publically available the results of quality reporting measures that apply to both ASCs and HOPDs.
Preventive care services allow medical problems to be discovered and treated earlier, saving money for Medicare, insurers and patients and, more importantly, saving lives. Colorectal cancer is a preventable disease. Nevertheless, it continues to kill 50,000 Americans each year.
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