On May 31, USA Today ran an opinion piece from American Cancer Society (ACS) and American Cancer Society Cancer Action Network (ACS CAN) CEO Gary Reedy calling on the president and the administration to close a loophole that is resulting in surprise bills for seniors on Medicare. Read it here.
Current law requires insurers to cover preventive services with an ‘A’ or ‘B’ rating from the United States Preventive Services Task Force with no cost sharing for patients. Colonoscopies get an ‘A’ rating for those aged 50 to 75. However, in Medicare if a pre-cancerous polyp is removed during the course of a routine screening colonoscopy, the test is being recoded from preventive to diagnostic and seniors are waking up to a bill in the hundreds of dollars. A third of seniors on Medicare are below 200% of the Federal Poverty Level and unexpected bills are unaffordable.
Patients have told ACS that the potential for a bill is causing them to delay or skip the lifesaving screening. An analysis done for the ACS CAN shows that up to 2,000 colorectal cancer cases could be avoided each year among seniors if Medicare were to make this change and treat screening colonoscopies when polyps are removed as a preventive service.
The previous administration closed this loophole in private insurance. In the USA Today commentary, Gary calls on the president and current administration to fix the problem for seniors on Medicare. The fix has bipartisan support and the president has been on record declaring surprise billing is a top priority.