News
Legislation in Congress aims to eliminate cost sharing for Medicare beneficiaries who have polyps removed during a colonoscopy.
Under the Affordable Care Act, preventive care services – including screening colonoscopy – are covered with no copayment or coinsurance to the patients. Under Medicare, however, colonoscopies are reclassified as "therapeutic" if polyps are removed during the procedure. In that case, patients must pay coinsurance of 20% of the Medicare approved charge. Changing the Medicare policy requires action by Congress.
Sen. Ben Cardin (D-Md.) introduced S.608, the Supporting Colorectal Examination and Education Now (SCREEN) Act, in March. The bill would waive cost sharing for Medicare beneficiaries if polyps were removed during a colonoscopy. The proposed legislation also calls for notifying all Medicare beneficiaries about the screening benefit and would cover a prescreening visit under Medicare.
Rep. Richard Neal (D-Mass.) introduced companion legislation n the House (H.R. 1320).
The SCREEN Act also would give physicians a chance to earn higher payments for providing colonoscopies. The legislation would create a preventive services payment modifier for colorectal cancer screening. Under the bill, physicians could earn incentive payments by meeting national colorectal cancer screening goals and minimum standards for knowledge, training, continuing education, and documentation.
At press time, the companion bills had been referred to committee; no other action had been taken.