This Week – May 23, 2015

This Week in Washington DC:

  1. May is Hepatitis C Awareness Month: Did you know the SCREEN Act also promotes more Hepatitis C Screening?

The SCREEN Act Reduces Barriers for Both Colorectal Cancer and Hepatitis C Screenings

U.S. Senator Ben Cardin (D-MD) and Representative Richard Neal (D-MA) recently 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.

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

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, which first require a primary care referral in order to be screened for Hepatitis C. Yet Medicare has concluded that our nation’s veterans and baby boomers account for two-thirds of the people with Hepatitis C in the U.S. and that roughly 85 to 90 percent of those infected with Hepatitis C 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 at the same time that the patient undergoes 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.

Please click here to access the infographic illustrating how the SCREEN Act removes barriers to HCV screening.

Urge Congress to support the SCREEN Act:

More on the SCREEN ACT

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 300 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.

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 in Congress resolving this issue as well.

The SCREEN Act goes one step further and waives cost-sharing under Medicare for required follow-up colonoscopy subsequent to other 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.

The SCREEN Act is the only legislation pending before Congress which specifically addresses this threat to colonoscopy reimbursement. 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.

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

Brad Conway