Congressman Dent Reintroduces Bill to Cover Colonoscopy Costs for Seniors

Quirk in existing health care law costs seniors

Congressman Charlie Dent (PA-15) reintroduced a bill today that eliminates an unintended hidden cost for Medicare beneficiaries who wisely choose to undergo this important screening test.  Called the Removing Barriers to Colorectal Cancer Screening Act, H.R. 1070 corrects a “Catch-22” in current law. 

Currently, seniors are not charged coinsurance for the colonoscopy procedure.  However, if a polyp is discovered during the screening and removed, which would be standard procedure, the senior faces having to cover the coinsurance of anywhere between $100 to $300. This occurs because the removal of the polyp or polyps triggers a change in the classification of the service provided from a “screening” service to a “therapeutic” or “diagnostic” service under Medicare’s billing codes.

It’s impossible to know whether a patient has a polyp before the screening. The result is the senior ends up having to make a large co-payment on a service they were told would not cost them anything out of pocket.

“This is a glitch in the law that needs to be changed,” said Rep. Dent. “We want more people to get colonoscopies. It is a life-saving screening procedure.”

Every year, over 140,000 Americans are diagnosed with colorectal cancer. Unfortunately, 50,000 Americans a year die from the disease. The Centers for Disease Control and Prevention (CDC) says that 60% of these deaths could be avoided if people undergo screenings. Specifically to the point of this legislation, stopping the disease in its tracks by identifying and removing precancerous polyps would reduce the number of new colorectal cancer cases by 76 to 90 percent, again according to the CDC.

“They say an ounce of prevention is worth a pound of cure,” Rep. Dent noted. “Consider the relatively low cost of this preventative service versus the gigantic costs of extensive cancer treatments and hospital stays that those suffering from colorectal cancer must endure. It’s not just dollars and cents, it is life or death,” concluded the Congressman.

Congressman Dent previously introduced the bill in the 112th Congress and it gained the support of the American Society for Gastrointestinal Endoscopy, the American Gastroenterological Association, the American Cancer Society Cancer Action Network Fight Colorectal Cancer, the American College of Gastroenterology, the Colon Cancer Alliance, the Prevent Cancer Foundation, the Society for Gastroenterology Nurses & Associates, the Pennsylvania Society of Gastroenterology and the Digestive Disease National Coalition.  

Congressmen Joe Courtney (D, CT-2), Michael Fitzpatrick (R, PA-8) and Donald Payne, Jr. (D, NJ-10) have signed on to the bill as original co-sponsors.

March is National Colorectal Cancer Awareness Month

Contact: Shawn Millan (610) 770-3490