This Week – May 2, 2015

This Week in Washington DC:

  1. ACG Board of Governors Descend Upon the U.S. Capitol
  2. Senator Ben Cardin and Congressman Richard Neal Introduce SCREEN Act

ACG Governors on Capitol Hill

On Thursday, April 30th, roughly fifty members of the ACG Board of Governors met with legislators and congressional staff to discuss important legislative priorities for GI practices and patients, and to educate policy makers on the most important local issues in your respective districts and states.

ACG thanks the ACG Governors for taking time away from their practices and families to participate in over 250 meetings on Capitol Hill!

(Left to right) Immanuel Ho, MD FACG, Chair of the ACG Board of Governors, Congressman Keith Rothfus (PA-12), and James Reynolds, MD FACG, ACG Governor for Eastern Pennsylvania

Senator Ben Cardin and Congressman Richard Neal Introduce SCREEN Act

U.S. Senator Ben Cardin (D-MD) and Representative Richard Neal (D-MA) introduced the “Supporting ColoRectal Examination and Education Now (SCREEN) Act” (S. 1079/H.R. 2035), which eliminates barriers to potentially lifesaving colorectal screenings for Medicare beneficiaries and ensures they are screened regularly through a variety of recommended methods, including colonoscopy. Both Senator Cardin and Congressman Neal have long advocated for increasing colorectal cancer screening in Medicare. Mr. Cardin has sponsored iterations of the SCREEN Act in each Congress since 2002, first as a member in the U.S. House of Representatives. ACG and over 200 private and public sector partners are also committed to an ambitious public health goal of screening 80 percent of eligible adults for colorectal cancer by 2018.

About the SCREEN ACT: Financial Barriers to Colorectal Screening Removed

The SCREEN Act aims to reduce barriers to colorectal screening among the Medicare population, a group at high risk for colorectal cancer based on age. Medicare currently waives cost-sharing by beneficiaries for any colorectal cancer screening test recommended by the United States Preventive Services Task Force (USPSTF). However, if a polyp is removed during the screening colonoscopy, the procedure is no longer considered a “screening” for Medicare purposes, and cost-sharing applies. The SCREEN Act waives cost-sharing when a polyp is removed during a screening colonoscopy. ACG supports and promotes other legislation resolving this issue as well.

The SCREEN Act goes further and also waives cost-sharing under Medicare for required follow-up colonoscopy subsequent to other recommended USPSTF recommended colorectal cancer screening tests. This removes all financial barriers for Medicare beneficiaries throughout the screening continuum, so that cost-sharing would not apply whether the colonoscopy was a preventive test or as the result of a positive finding from another screening modality.

Not only does the SCREEN Act address barriers to colorectal screening for Medicare beneficiaries, but it also implements a three-year freeze in Medicare reimbursement for colonoscopy for those providers who participate in nationally recognized quality improvement registries, meaning the 2015 rates will remain the same until 2018. The goal is to encourage quality benchmarking at a time when Medicare reimbursement for these services remains under significant pressure. The SCREEN Act is the only legislation pending before Congress which specifically addresses this threat to colonoscopy reimbursement.

The SCREEN Act also establishes an innovative Medicare demonstration project which allows for an office visit to discuss colonoscopy preparation and patient questions. This pre-screening visit would also serve as an opportunity for Medicare beneficiaries to discuss Hepatitis C screening with their provider.

Offering age-appropriate Hepatitis C screening at the same time as colonoscopy combines two important public health imperatives in the same encounter. The SCREEN Act makes this even easier by providing an alternative pathway to current Medicare rules, where a referral is first required from only a primary care physician prior to Hepatitis C screening. Yet most Medicare beneficiaries are asymptomatic, meaning there would need to be another reason for the beneficiary to see a primary care physician and get this referral. Recent findings demonstrate that more patients will elect to undergo a Hepatitis C screening test if it is offered by a gastroenterologist at the same time that the patient schedules a screening colonoscopy. At a time when alternative payment models are under development and consideration, this demonstration project aims to improve quality of care and care coordination, but also reimburse ACG members for services not currently paid for – or allowed under – current Medicare coverage rules.

Urge Congress to support the SCREEN Act: Click here:

Please stay tuned for further updates. Please also share and discuss your thoughts with fellow ACG members on the ACG GI Circle. To login and share your comments, go to and sign in as a member. Once you have done so, click here and then click the orange “Visit ACG GI Circle” button to be taken to the GI Circle site. If you have not yet activated your ACG GI Circle account, please email us at

Contact Brad Conway, VP Public Policy, with any questions or for more information.

Brad Conway