Q&A: CRC screening bill removes unexpected costs for polyp detection, removal
The organization Fight Colorectal Cancer is celebrating that the Removing Barriers to Colorectal Cancer Screening Act has been recently signed into law.
According to a press release from Fight CRC, the organization has been advocating for the bill to be signed into law since 2012. The legislation was initially introduced when advocated from both Fight CRC and the American Cancer Society Cancer Action Network shared their stories. The ‘Medicare loophole’ bill was included in a legislation package that addressed COVID-19 relief, passed by Congress on Dec. 21, 2020, and later signed into law by former president Donald Trump on Dec. 27, 2020.
The law protects Medicare patients from receiving an unexpected bill if polyps are detected and removed during screening colonoscopy, according to the release.
Healio Gastroenterology spoke with Molly McDonnell, the advocacy director at Fight CRC on the passing of the recent legislation and how it impacts billing of CRC screening.
Healio: What does passing the Removing Barriers to Colorectal Cancer Screening Act mean?
McDonnell: The passage of the Removing Barriers to Colorectal Cancer Screening Act means that more seniors will have access to potentially life-saving colorectal cancer screening. Prior to this law taking effect, if a Medicare beneficiary underwent a screening colonoscopy and polyps were detected and removed, they could wake up with a several hundred-dollar bill. This legislation will gradually phase out that out-of-pocket cost over time, completely removing it by 2030.
Healio: Will there be changes to CRC screening?
McDonnell: The way screening is performed and recommended hasn't changed based on this bill, only the way patients may or may not be billed. As I mentioned earlier, with the passage of this legislation, if a Medicare beneficiary undergoes a screening colonoscopy and polyps are detected and removed, they will face a lower and lower out-of-pocket cost until it is completely removed in 2030. We believe that removing this financial barrier will help increase access to colorectal cancer screening and ultimately save lives.
Healio: What is the goal after passing this act for screening?
McDonnell: Fight Colorectal Cancer is a proud partner in the effort spearheaded by the National Colorectal Cancer Roundtable to reach 80% screening in every community. We believe the passage of the Removing Barriers to Colorectal Cancer Screening Act is a key part of reaching that goal. It will also be important for us to raise awareness about this change among Medicare beneficiaries.
After the passage of this legislation, we are turning our attention to ways to support and convene researchers to keep discovering new prevention and treatment strategies. The reality is, there is still not a cure for this disease and until there is, there will always be more work to do.
Healio: What’s next?
McDonnell: The Removing Barriers to Colorectal Cancer Screening Act, while incredibly important, is only one piece of the puzzle. COVID-19 has had a significant impact on colorectal cancer screening. According to data from Fight CRC and Komodo Health, the total number of colonoscopies and biopsies performed declined nearly 90% by mid-April 2020 compared with the same period in the year prior due the COVID-19 pandemic. New colorectal cancer diagnoses declined more than 32% over the same period, which means people were likely not getting screened. Further, the National Cancer Institute estimates there will be over 4,500 excess deaths from colorectal cancer due to delays in screening and treatment.
It is critical that individuals not postpone cancer screenings, and they talk with their health care providers about the precautions they are putting in place to keep patients safe.
It’s important to note, however, that colorectal cancer screening is unique. At-home, non-invasive screening tests are available that can help mitigate the backlog of colonoscopy screenings. This may be a good option for patients hesitant to be screened right now.
All patients who receive a positive result on a non-invasive colorectal cancer screening test should receive a follow-up colonoscopy to complete the colorectal cancer screening process. Unfortunately, many patients face out-of-pocket costs with that follow-up colonoscopy, which creates a barrier to completing screening. This is why our advocacy efforts continue, even on a state level Fight CRC’s Catalyst State-by-State Advocacy Program is supporting state coalitions to advance policy to increase colorectal cancer screening, including removing out-of-pocket costs for colonoscopy following a positive non-invasive test.
There is more work to do, millions to be screened, and Fight CRC will be here helping to push policymakers to make decisions that get it done.