Call-On Congress 2012: Coinsurance Webinar #2

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This prep material partners with the video and is for participants attending ConC 2012 - it is presented by Camille Bonta for the workshops she will lead at the Fight Colorectal Cancer conference. …

This prep material partners with the video and is for participants attending ConC 2012 - it is presented by Camille Bonta for the workshops she will lead at the Fight Colorectal Cancer conference. This is the second part of the three part series

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  • 1. Medicare Cost Sharing for Screening Colonoscopy Preparing to Talk with Members of Congress about Cost Barriers to Colorectal Cancer Screening for Medicare Beneficiaries Presented by: Camille Bonta, MHS Call-on Congress March 5-7, 2012
  • 2. Medicare Cost Sharing for Screening Colonoscopy
    • Current Medicare Law
      • Colorectal cancer screenings are free, including screening colonoscopy.
      • However , if polyp is removed during colonoscopy, Medicare beneficiary must pay coinsurance.
  • 3. Medicare Cost Sharing for Screening Colonoscopy
    • Cost Sharing Definitions
      • Deductible : Amount insured has to pay out of pocket for expenses before insurer will cover the remaining costs.
      • Coinsurance : Set percentage that insured must pay of the covered costs after the deductible has been reached.
  • 4. Medicare Cost Sharing for Screening Colonoscopy
    • Colorectal Cancer Screening Coverage and Cost Sharing History
      • 1998: Medicare coverage of screening colonoscopy for high-risk individuals.
      • 2001: Medicare coverage of screening colonoscopy for average-risk individuals.
  • 5. Medicare Cost Sharing for Screening Colonoscopy
    • Colorectal Cancer Screening Coverage and Cost Sharing History
      • 2005: Deficit Reduction Act waived Medicare beneficiary deductible for colorectal cancer screening.
        • However, if a polyp was removed during screening colonoscopy, beneficiary was liable for the deductible.
  • 6. Medicare Cost Sharing for Screening Colonoscopy
    • Colorectal Cancer Screening Coverage and Cost Sharing History
      • 2010: Affordable Care Act corrected previous law. Now deductible is always waived, even if a polyp is removed during a screening colonoscopy.
  • 7. Medicare Cost Sharing for Screening Colonoscopy
    • Colorectal Cancer Screening Coverage and Cost Sharing History
      • 2010: Affordable Care Act waives coinsurance for colorectal cancer screenings.
        • Colonoscopy, Sigmoidoscopy, FOBT
      • But, Medicare beneficiary must still pay coinsurance if polyp is removed during screening colonoscopy.
  • 8. Medicare Cost Sharing for Screening Colonoscopy
    • Fight Colorectal Cancer’s Request to Congress
      • Congressional Action is Needed this Year to Correct Coinsurance Gap
        • House legislation poised for introduction (H.R. ????)
        • Similar legislation will be needed in the Senate
  • 9. Medicare Cost Sharing for Screening Colonoscopy
    • Key Messages
      • Current Medicare policy is confusing.
      • Creates disincentive to screening.
      • Trends in decreased colorectal cancer incidence could stall or decline.
      • Coinsurance “gap” due to unintentional oversight in the law.
  • 10. Medicare Cost Sharing for Screening Colonoscopy
    • Key Messages
      • Screening colonoscopy is the most effective test for the prevention of colorectal cancer.
        • Allows for the removal of potentially precancerous polyps during the procedure.
      • Screening colonoscopy is a unique preventive service.
  • 11. Medicare Cost Sharing for Screening Colonoscopy
    • Parting Words
      • An effective advocate ties their personal story with key messages and facts.
      • Colorectal cancer prevention has a history of bipartisan support.
      • Despite claims, colorectal cancer screenings are not “free” for all Medicare beneficiaries.
      • Congress needs to take action this year.
  • 12. Thank You! www.FightColorectalCancer.org