Topics:

Medicare Bill Expands Cancer Screening

Medicare Bill Expands Cancer Screening

The Medicare bill that Congress passed in December 2000 (H.R. 5661) didn’t help oncologists or any other medical specialty in terms of increasing payment in such pressing areas as chemotherapy administration. Instead, the bill gave big bucks to hospitals, HMOs, and nursing homes, whose administrators have been complaining about the 1997 Balanced Budget Act, which made major Medicare program changes and which put them all in dire financial straits. However, H.R. 5661 did contain two separate cancer provisions that will be welcomed by oncologists. First, the bill expanded Medicare cancer screening benefits for pap smears, colonoscopy, and mammography. For the first time, women under age 40 but over age 35 can receive one screening mammogram during a 5-year period. These women, of course, must be Medicare recipients (ie, disabled).

Pam Dougherty, manager of federal government relations for the American Cancer Society, says her group pressed Congress to expand the colonoscopy benefit. Currently, Medicare recipients can receive a sigmoid colonoscopy every 2 years—but only if they are at high risk for colorectal cancer. The new bill allows average-risk individuals to receive a sigmoid colonoscopy once every 10 years. "That is a huge victory," exclaims Dougherty. The Medicare colorectal screening benefit also allows a fecal occult blood test every year, plus a flexible sigmoidoscopy every 4 years for average-risk individuals.

Besides the bill’s expansions in cancer screening, H.R. 5661 also instructs Tommy Thompson, who is nominated to be secretary of the Department of Health and Human Services (HHS), to develop nine pilot projects aimed at reducing disparities in the early detection and treatment of cancer among minorities. Two projects will ensue for each of the following groups: American Indians and Eskimos, Asian Americans, Blacks, and Hispanics. The HHS has 1 year to determine the "best practices" for reducing the disparities, with 1 additional year to designate the nine demonstration projects. The projects will also attempt to improve clinical outcomes, patient satisfaction, and quality of life. If these pilots prove successful after 2 years, they may be continued; and if this occurs, there is no doubt that Congress will expand the program.

 
Loading comments...

By clicking Accept, you agree to become a member of the UBM Medica Community.