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

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