Seniors in our districts and across the country depend on Medicare to cover important cancer prevention tests, such as colonoscopies. With the current Medicare reimbursement rules, many seniors may opt to forgo this potentially lifesaving test due to their inability to pay for the unexpected co-pay for the removal of any polyps discovered during the procedure.
Many seniors, understandably, believe that Medicare will fully cover the cost of the colonoscopy and possible polyp removal as is now the case with private insurance due to changes included in the Affordable Care Act. They are justifiably surprised to find out that although current Medicare treats routine colonoscopies as a free preventive service, patients must share in the cost if a polyp is removed during the procedure. That cost sharing requirement can worry seniors anew about whether they can afford the test.
Colonoscopies are vitally important because they can actually prevent cancer with the removal of pre-cancerous polyps that are discovered during the procedure. The problem is that a colonoscopy that was intended to be preventive will often be coded as a diagnostic procedure for billing purposes if a polyp is found. Last year, the Centers for Medicare and Medicaid Services clarified that people with private insurance should not have to pay when a polyp is removed during a preventive colonoscopy. We believe that should be the case for seniors on Medicare — the population at greatest risk for the disease — as well.
Critical legislation is sitting before both chambers of Congress that would ensure that cost is not a barrier for Medicare beneficiaries trying to access lifesaving colon cancer screenings. Our legislation, “The Removing Barriers to Colorectal Cancer Screening Act” (H.R. 1070), also sponsored by Sen. Sherrod Brown, D-Ohio, in the Senate (S. 2348), would eliminate cost sharing for Medicare beneficiaries receiving a routine screening colonoscopy, even when a polyp is removed. This lifesaving legislation would help to ensure that everyone has access to colon cancer screening, regardless of their ability to pay.
Colorectal cancer takes a tremendous toll on our country year after year. According to the American Cancer Society, it’s the second leading cause of cancer death for men and women combined. Each year, more than 140,000 new cases of colorectal cancer are diagnosed and approximately 50,000 preventable deaths occur. Not only is the disease devastating to patients and their families, but treatment of colon cancer costs approximately $14 billion per year.
The good news is colon cancer is very treatable if it is detected early. In fact, if Americans received regular screenings for colon cancer, half of all colon cancer deaths could be prevented. Shouldn’t we be doing everything we can to ensure every American has access to these lifesaving cancer screenings?
Colon cancer’s devastating impact on families is something we have both experienced first-hand. That’s why we’ve joined with more than 100 organizations to support a nationwide goal to increase colorectal cancer screening rates of Americans age 50 and older to 80 percent by 2018. By supporting the “Removing Barriers to Colorectal Cancer Screening Act,” our colleagues in the House and friends in the Senate would play a major role in helping to reach the 2018 goal and reducing the incidence and cost of colorectal cancer.
Rep. Elijah Cummings, D-Md., right, hugs Harold Schaitberger, General President of the International Association of Fire Fighters, after the Congressman spoke at the IAFF's Legislative Conference General Session at the Hyatt Regency on Capitol Hill, March 9, 2015. The day featured addresses by members of Congress and Vice President Joe Biden.