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Federal Legislative Activity Spotlights Need For More Colorectal Cancer Screening Programs

Garry Carneal, JD MA
PCC Board of Directors
President & CEO, Schooner Healthcare Services, LLC

With healthcare reform getting most of the headlines in recent months, it is important to note that additional legislation has been introduced that would beef up colorectal cancer screening initiatives. During the 111th Congress (2009-2010), at least three dozen bills that draw attention to the need to increase colorectal cancer screening rates and treatment options for targeted populations within the U.S. have been filed and assigned to Congressional Committee. Of course the biggest news this past spring was the adoption of the “Patient Protection and Affordable Care Act,” (PPACA) which the President signed into law in March. Among other benefits, the new law promotes colorectal cancer screening tests directly for Medicare enrollees as highlighted in Table 1 below. In addition, the PPACA could open up new opportunities to ensure individuals with colorectal cancer can continue to receive treatments during the course of the illness. Among other changes, provisions that will take effect during the next 12 months that might help colorectal cancer patients include:

Table 1:

The Patient Protection and Affordable Care Act

PL 111-148 (HR 3590); March 23, 2010

Actual Language from the New Law Referencing “Colorectal Cancer”

SEC. 4104. REMOVAL OF BARRIERS TO PREVENTIVE SERVICES IN MEDICARE.

………..

(c) WAIVER OF APPLICATION OF DEDUCTIBLE FOR PREVENTIVE SERVICES AND COLORECTAL CANCER SCREENING TESTS.--Section 1833(b) of the Social Security Act (42 U.S.C. 1395l(b)), as amended by section 4103(c)(4), is amended--

(1) in paragraph (1), by striking "items and services described in section 1861(s)(10)(A)" and inserting "preventive services described in subparagraph (A) of section 1861(ddd)(3) that are recommended with a grade of A or B by the United States Preventive Services Task Force for any indication or population and are appropriate for the individual."; and

(2) by adding at the end the following new sentence: "Paragraph (1) of the first sentence of this subsection shall apply with respect to a colorectal cancer screening test regardless of the code that is billed for the establishment of a diagnosis as a result of the test, or for the removal of tissue or other matter or other procedure that is furnished in connection with, as a result of, and in the same clinical encounter as the screening test.".

Notes: Emphasis added to the above quote. The terms “Colorectal Cancer” or “Colorectal” are not referenced in the 'Health Care and Education Reconciliation Act of 2010' which was the second bill signed by the President this spring.

In addition, Table 2 highlights a handful of interesting bills still pending in Congress addressing colorectal cancer. Although the PPACA has taken some of the limelight, many public policy advocates are still pushing for additional programs to support colorectal cancer screening and treatment options.

Table 2:

Congressional Bills Supporting Colorectal Cancer Screening and Treatment Programs

H.R. 1189: “The Colorectal Cancer Prevention, Early Detection and Treatment Act” would establish one or more grant programs through the Centers for Disease Control and Prevention (CDC) to provide colorectal cancer screenings and treatment for low-income, uninsured and underinsured individuals who are not eligible for Medicare.

  • The bill has 78 co-sponsors.
  • Last Action: The bill has been referred to the House Committee on Energy and Commerce on February 25, 2009.

H.R. 2115: “Men and Families Health Care Act” would establish through the Department of Health and Human Services (HHS) a new office known as the “Office of Men’s Health” which among other responsibilities would “coordinate public awareness programs and activities, including….colorectal cancer screening programs.”

  • The bill has 5 co-sponsors.
  • Last Action: The bill has been referred to the House Committee on Energy and Commerce on April 27, 2009.

H.R. 1330: “The Colorectal Cancer Screening and Detection Coverage Act” requires private health insurance plans to provide coverage for colorectal screening for any participant or beneficiary who is 50 years of age or older or at high risk for colorectal cancer under terms and conditions that are no less favorable than those applicable to other screening benefits provided under the plan. The bill sets forth some exceptions, including limiting the amount of coinsurance for such screenings and limiting waiting periods.

  • The bill has 24 co-sponsors.
  • Last Action: House Education and Labor: Referred to the Subcommittee on Health, Employment, Labor, and Pensions on April 29, 2009.

H.R. 2559/S 1511: “Supporting ColoRectal Examination Now (SCREEN) Act” would amend key federal programs such as Medicare and Medicaid to promote colorectal cancer screening tests to geared to a number of high risk populations.

  • The House bill has 2 co-sponsors; the Senate version has 3 cosponsors.
  • Last Actions:
    • Referred to House Ways and Means Committee on Sep 14, 2009.
    • Referred to the Committee on Finance on July 23, 2009.

H.Res. 1053: “Recognizing that Women Are Equally Affected by Colon Cancer” bill would recognize that women are equally affected by colon cancer, and the importance of colon health in women and of detecting colon cancer in its earliest stages.

  • The bill has 40 co-sponsors.
  • Last Action: Referred to the House Committee on Energy and Commerce on February 2, 2010.

Other Congressional bills of Interest:

  • H.Res. 1114: “Supporting the Observance of Colorectal Cancer Awareness Month and for other Purposes” (Referred to the House Committee on Energy and Commerce on Feb 25, 2010).
  • H.R. 4563: “Cancer Screening Coverage Act” (Referred to the Subcommittee on Health, Employment, Labor, and Pensions on Feb 23, 2010).
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