Screen Act for 112th Congress
Floor Speech
* Mr. NEAL. Mr. Speaker, I rise today to introduce the Supporting Colorectal Examination and Education Now (SCREEN) Act. This legislation will remove barriers to one of the most effective preventive health screenings available, saving lives and reducing health care costs in the process. I urge all of my colleagues to support this important legislation.
* The statistics surrounding colon cancer are startling. Colon cancer is the number two cancer killer in the United States for both men and women. (CDC Colorectal Cancer Vital Signs; July 2011)
* Over 50,000 people will die this year from this disease according to the American Cancer Society (2010 Fact & Figures).
* These deaths become more tragic when one considers that colorectal cancer is highly preventable with appropriate screening. According to the American Cancer Society (2010 Facts & Figures), the 5 year survival rate is 90% for those diagnosed at an early stage; however, less than 40% of the cases are diagnosed at that stage.
* During colorectal cancer screening by colonoscopy, pre-cancerous polyps are removed during the same encounter, thus preventing cancer from developing, as opposed to other cancer screenings where early detection is the goal. That is one reason why the U.S. Preventive Services Task Force provides an ``A'' rating for CRC screenings.
* The CDC ``colorectal cancer control program'' screening target rate is 80%. The American Cancer Society and other patient advocacy groups have a target rate of 75%. Unfortunately, only half of the Medicare population is being screened, despite the availability of a Medicare colon cancer screening benefit. According to CMS and American Cancer Society (March 2011), Medicare claims indicate that only 52-58% of beneficiaries have had any colorectal cancer test and there is ``clearly an opportunity to improve colorectal cancer screening rates in the Medicare population.''
* The latest findings by the American Cancer Society confirm that screening rates among the Medicare population continue to be in this 50th percentile range, with screening rates among minority populations that are especially low among Medicare-aged beneficiaries.
* The CDC concludes that 1,000 additional colorectal cancer deaths will be prevented each year if screening rates reached 70.5%. (CDC Colorectal Cancer Vital Signs; July 2011).
* In addition to saving lives, colorectal cancer screening has been demonstrated to save Medicare long-term costs as noted by the New England Journal of Medicine in a recent article (Feb. 2008).
* The direct costs of treating colorectal cancer in 2010 reached $4 billion. (CDC Colorectal Cancer Vital Signs; July 2011)
* I am pleased that Congress took steps to improve access to life-saving colon cancer screening when it passed the Patient Protection and Affordable Care Act (PPACA) in March 2010.
* While Congress has made tremendous strides in increasing colorectal cancer utilization rates in PPACA, this bill will further make live saving screenings more accessible to Medicare beneficiaries.
* Currently, Medicare waives cost-sharing for any colorectal cancer screening recommended by the U.S. Preventive Services Task Force. However, should the beneficiary have a precancerous polyp removed, the procedure is no longer considered a ``screening'' for Medicare coding purposes.
* The unintended consequence of this is that the beneficiary is obligated to pay the Medicare coinsurance because the procedure is no longer a ``screening.'' However, the purpose of the screening is to find and remove precancerous polyps.
* The SCREEN Act waives all Medicare beneficiary cost-sharing for colorectal cancer screenings that become ``therapeutic'' or diagnostic procedures.
* The legislation also resolves this unintended consequence for beneficiaries participating in health insurance exchanges beginning in 2014.
* The SCREEN Act also provides incentives for Medicare providers to participate in nationally recognized quality improvement registries so that our Medicare beneficiaries are in fact receiving the quality screening they deserve.
* Lastly, the SCREEN Act removes barriers to screening rates by allowing a Medicare beneficiary to sit down and discuss the importance of the procedure before seeing the provider for the first time right before procedure. The federal government and colorectal cancer patient advocacy groups have concluded that the ``fear of the procedure'' is a major impediment to increasing colorectal cancer screening rates.
* Promoting access to colorectal cancer screening is good policy. It will save lives and reduce costs to families and the health care system. Please join with me in the fight against colorectal cancer by cosponsoring this legislation.
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