Exact Sciences backs CMS policy update to waive cost-sharing for follow-up colonoscopy
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Exact Sciences announced its support for recent policy changes that aim to increase access to noninvasive colorectal cancer screening tests and require Medicare and most insurers to pay for colonoscopy after a positive stool-based test.
The company, which manufactures the stool-based DNA and hemoglobin screening test Cologuard, joined other industry partners and the AGA, the American Cancer Society Cancer Action Network and Fight Colorectal Cancer to advocate for policy updates and eliminate out-of-pocket cost barriers to CRC screening.
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According to an Exact Sciences press release, the recent changes come from additional implementation of Affordable Care Act guidelines and revised regulations adopted by CMS, which structured the changes to, “Expand access to quality care and improve health outcomes through early detection, more effective treatment and reduce mortality.”
“This is a huge win for our patients,” David Lieberman, MD, AGAF, professor of gastroenterology and hepatology at Oregon Health & Science University and chairperson of the AGA committee on CRC screening, said in the release. “This change will help providers address a major CRC screening gap for people who were previously burdened by the cost of a follow-up colonoscopy. We know disparities exist in CRC screening. There are data which show that when we increase access to colorectal cancer screening and help navigate patients needing a follow-up.”
The policy updates, which take effect Jan. 1, 2023, may not apply to some commercial insurance plans exempted under the ACA, the release states.
“As a cancer diagnostics leader, we must continue to partner with all stakeholders across health care to increase access and make it easy for all Americans to receive recommended cancer screenings,” Kevin Conroy, CEO and chairman of Exact Sciences, said in the release. “These changes help remove a key financial barrier.”
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