The Introduction of the Colon Cancer Screening for Life Act

Floor Speech

THE INTRODUCTION OF THE COLON CANCER SCREENING FOR LIFE ACT

* Mr. NEAL of Massachusetts. Madam Speaker, I rise today in support of the Colon Cancer Screen for Life Act, which I am introducing along with Congressman Phil English (R-PA) and Congressman Ed Towns (D-NY). According to the American Cancer Society, this year alone, 52,180 Americans will die from colon cancer. In my own state of Massachusetts, 1,180 people will lose their life to this deadly disease. What makes statistics such as these all the more tragic is that unlike other forms of cancer, colorectal cancer is highly detectable and even treatable if it is caught early through a colonoscopy screening examination.

* Recognizing the importance of early intervention, Congress acted to provide Medicare coverage for colorectal cancer screening (CRC) through colonoscopy in the Balanced Budget Act of 1997 and further expanded in 2000 when the colonoscopy benefit was added for high risk beneficiaries. Under this benefit, a low risk beneficiary is entitled to receive a colonoscopy once every ten years and a high risk beneficiary is entitled to a colonoscopy every two years. Despite this, recent studies have shown that patients are not utilizing coverage of CRC preventive screenings. According to the Government Accountability Office (GAO), since the implementation of the benefit in 1998, the percentage of Medicare beneficiaries receiving either a screening or a diagnostic colonoscopy has increased by only one percent.

* A key reason for the low rate of colonoscopy screening in the Medicare population is rapidly declining rates of reimbursement for the procedure. Medicare reimbursement for colonoscopies performed in the outpatient setting has dropped by 33 percent from the initial 1998 levels. In many states today, Medicaid payment rates actually exceed Medicare reimbursement for colonoscopy. Unless we reverse this trend toward declining reimbursement, physicians will no longer be able to offer colonoscopies to Medicare beneficiaries. This bill increases Medicare reimbursement rates by 30 percent for colonoscopies performed in an outpatient setting, and by 10 percent for procedures performed in the physician's office, to ensure that Medicare beneficiaries have access to these lifesaving procedures. Moreover, increasing colonoscopy screening rates will generate significant long-term savings for the Medicare program, in the form of foregone costs for costly colorectal cancer treatment.

* Medicare also does not currently pay for a physician office visit prior to a screening colonoscopy. Colonoscopy procedures involve sedation, so physicians generally do not perform them without an office visit prior to the procedure to obtain the patient's medical history and to educate the patient about the steps he or she needs to take in order to prepare for the colonoscopy. A number of states actually require this pre-operative consultation. Medicare pays for this pre-operative visit when a colonoscopy is being performed in order to diagnose a patient--but it does not pay for such a visit prior to screening colonoscopies, even though the procedure is the same and presents the same risks to the patient. This bill fixes this discrepancy by providing Medicare reimbursement for the office visit that takes place prior to the screening colonoscopy.

* Finally, reducing financial requirements on beneficiaries will encourage more people to take advantage of this preventive benefit. It was with this intent that Congress agreed to waive the Part B deductible as part of the Deficit Reduction Act of 2005. Unfortunately, since that time, CMS has misinterpreted this provision of law, claiming that the deductible is only waived if the beneficiary has a ``clean'' screening, but maintaining that the deductible still applies if the screening results in taking a biopsy or if a cancerous or pre-cancerous polyp. Under this nonsensical policy, a beneficiary is left not knowing whether or not the deductible is waived until after the screening. Those whose ability to pay is limited are therefore simply choosing not to take the risk. This bill would require that the deductible be waived for all screenings, regardless of the outcome.

* Madam Speaker, as the old saying goes, ``an ounce of prevention is worth a pound of cure.'' This bill embodies this wisdom. In passing the Colon Cancer Screen for Life Act, we will not only be able to save lives but we will also be able to save money. According to the American Cancer Society, 153,760 new cases were diagnosed this year. Each of these cases will cost Medicare between $35,000 and $80,000 per patient to treat. For the bargain price of a little over $200 dollars, we can stop this cancer before it starts. Seems to me that is not only the right thing to do, it is the smart thing to do.

* I hope my Colleagues agree and will join me and Representatives English and Towns in support of this important piece of legislation.

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