FOR IMMEDIATE RELEASE
February 8, 2002

Contact: Rob Sawicki
Phone: 202.224.4041

Colon Cancer "Screen for Life" Act of 2002 Summary

• Colon cancer causes nearly 57,000 deaths each year. It is the third most commonly diagnosed cancer and the second most common cause of cancer-related death in America.

• Early detection through screening is medicine's most effective weapon to prevent and treat this deadly disease. The colonoscopy is the most definitive diagnostic and screening procedure for colon cancer, resulting in higher colon cancer identification rates and better long-term survival due to early detection.

• Ninety-three percent of all colon cancers could be prevented if people received appropriate screening. Yet since the preventive benefits were enacted in 1997, there has been only a one percent increase in utilization by Medicare beneficiaries of either a screening or diagnostic colonoscopy.

• Unfortunately, barriers to screening still exist. When patients undergo either a screening or diagnostic colonoscopy, they will need to have a pre-procedure appointment. However, Medicare only pays for the pre-procedure appointment prior to a diagnostic colonoscopy. The pre-procedure visit is no less necessary in the case of a screening colonoscopy and should be covered.

• Also, since 1998, Medicare reimbursement for colonoscopies performed in the hospital setting has decreased by nearly 36%, while payment for colonoscopies performed in a doctor's office has increased 52%. The hospital setting ensures vital safety regulations are followed, while a doctor's office is unregulated. CMS reimburses more for the procedure to be done in a doctor's office thereby creating incentives to perform procedures in a less safe setting. This policy could put a patient's health at risk and is particularly dangerous for our frail elderly.

• The Screen for Life Act would make three changes to current law. First it would increase the payment rates for colon cancer screening tests performed in hospitals and outpatient facilities. Specifically, the payment rates in hospitals and outpatient facilities would increase by 30 percent above the procedures done in 2001, while payment for procedures done in physician's offices would increase by 10 percent.

• Second, the bill would require Medicare to pay for an office visit with a doctor prior to a screening colonoscopy to ensure beneficiaries are properly prepared and educated before the procedure.

• Finally, just as Congress has done for screening mammography, this bill would exempt colon cancer screening tests from the usual Medicare Part B deductible. By reducing the financial burden on beneficiaries, the bill will encourage more people to take advantage of the colon cancer screening benefit.