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ACR, CRC patient advocacy groups urge Congress to pass Medicare coverage for CT colonography
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The American College of Radiology and a number of patient advocacy groups have called on congress to pass the CT Colonography Screening for Colorectal Cancer Act, which would provide Medicare coverage of this American Cancer Society-recommended screening exam for seniors, according to a press release.
“A third of those who should be screened for colorectal cancer can’t have or won’t get a colonoscopy,” Eric Hargis, CEO of the Colon Cancer Alliance, said in the press release. “CT colonography increases screening rates where offered. Medicare coverage would provide seniors with insured access to an exam that may appeal to them. This would jump-start screening, catch more cancers early and saves more lives.”
CT colonography has also been shown to reduce costs; a recent study showed screening Medicare patients with CT colonography would cost 29% less compared with optical colonoscopy, corresponding to $1.7 billion in savings per screening cycle, according to the press release.
“Medicare coverage for virtual colonoscopy would provide access to a proven test that more seniors may use. This is vital,” Carolyn R. Aldigé, president and founder of the Prevent Cancer Foundation, said in the press release. “Colorectal cancer is one of the few cancers that we can often prevent. Detecting precancerous polyps can stop them from becoming cancer. This saves lives.”
Major insurers cover CT colonography, including CIGNA, UnitedHealthcare and Anthem Blue Cross Blue Shield, and more than 20 states require coverage of CT colonography by insurers, while Medicare does not cover the procedure.
“In order to increase screening rates amongst seniors, Medicare must cover virtual colonoscopy,” Anne Carlson, executive director of the Colon Cancer Coalition, said. “Not only will coverage of these exams increase screening rates, but it would save money and lives.”
The U.S. Preventive Services Task Force recently issued draft recommendations naming CT colonography an alternative screening exam, and the American Cancer Society strongly supported the procedure in its comments to the task force. Similarly, the ACR has called for the task force to reclassify the procedure as a “recommended screening exam.” The task force did not grade specific screening exams, and under the Affordable Care Act, private insurers are only required to cover exams graded A or B, while Medicare determines coverage for its beneficiaries separately.
“At present, seniors who want a CT colonography have to pay for the exam out of pocket — on top of the annual Medicare premium,” Anjee Davis, president of Fight Colorectal Cancer, said in the press release. “Many, who might not get tested otherwise, can’t overcome this financial barrier. Congress can provide seniors with the same screening options as the privately insured by passing S. 2262.”
The CT Colonography Screening for Colorectal Cancer Act is cosponsored by Sen. James Inhofe (R-OK) and Sen. Bill Nelson (D-FL), according to the press release.
“Colorectal cancer is almost always treatable if found early by screening and the cost to screen and prevent the disease is exponentially less than to treat cancers not found until advanced stage,” Judy Yee, MD, chair of the American College of Radiology Colon Cancer Committee, said in the press release. “Passage of S. 2262 can help save lives and reduce screening exam costs.”