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Medicare's Colonoscopy Loophole Could Cost Your Patients

Contact your federal lawmakers to support a co-pay fix.

Published: July 17, 2014

Proposals to fix the way Medicare collects colonoscopy co-pays from its beneficiaries are currently under consideration by both houses of the U.S. Congress.

Backers say House Bill 1070 and Senate Bill 2348, known jointly as the "Removing Barriers to Colorectal Cancer Screening Act," would improve patients' access to colonoscopies and in so doing reduce the incidence of colon cancer.

The co-pay fix is necessary due to an inadvertent loophole in 2010's Affordable Care Act. The healthcare reform law waived Medicare's co-insurance payments for colorectal cancer screenings. But if a diagnostic procedure discovers a polyp and the endoscopist removes it, the procedure is then classified as therapeutic and the patient is on the hook for the co-pay. (Commercially insured patients do not face this loophole.)

Colorectal cancer prevention and treatment advocates are urging surgical facilities to lend their support to the proposed co-pay fix by contacting their federal lawmakers. The Ambulatory Surgery Center Association makes it easy to identify and e-mail your U.S. senators and representatives on the issue.

David Bernard


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