Statement of Representative Richard Neal on Introduction of the SCREEN Act
• 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. Nearly 50,000 people will die this year from this disease. According to the American Cancer Society (2009 Fact & Figures), of the nearly 50,000 people expected to die from colorectal cancer in 2009, early detection could save more than half. These statistics alone are a tragedy.
• But the statistics become even more tragic when one considers that colorectal cancer is highly preventable with appropriate screening. And the disease is detectable, treatable, and curable if found early. According to the American Cancer Society (2009 Facts & Figures), the 5 year survival rate is 90 percent for those diagnosed at an early stage; however, only 40 percent of the cases are diagnosed at the stage.
• The U.S. Preventive Services Task Force (USPSTF) recognizes the preventable nature of this disease and provides its only grade ‘A’ recommendation of cancer screenings for colorectal cancer screens.
• Unfortunately, almost half of the Medicare population is not being screened, despite the availability of a Medicare colon cancer screening benefit. According to CMS, Medicare claims indicate that only 52 percent of beneficiaries have had a colorectal cancer test and there is “clearly an opportunity to improve colorectal cancer screening rates in the Medicare population.” (CMS website “overview of colorectal cancer screening”)
• Numerous barriers account for this fact, including structural issues in the Medicare program, significant Medicare cuts to providers, and lack of knowledge and preparation among patients.
The SCREEN Act
• The SCREEN Act is designed to address these barriers and increase the participation of patients in this preventive service. The bill accomplishes this is several main ways.
Reducing Patient Barriers
• First, the bill would reduce patient barriers to being screened. The legislation would waive Medicare co-insurance for diagnostic and screening colorectal cancer tests in order to increase utilization.
• In addition, the bill would provide coverage for a pre-operative visit with a physician prior to a screening colonoscopy. This is the standard of care, but is not currently covered by Medicare.
• Finally, under the legislation all Medicare beneficiaries will be notified about the Medicare colorectal cancer screening benefit and reminded of the benefits periodically.
• These common sense steps will ensure that more patients are screened and more lives are saved.
Provider Quality and Accessibility
• We must also ensure that there are adequate numbers of high-quality physicians performing colonoscopies. The legislation reverses years of provider reimbursement cuts by creating a preventive services payment modifier for colorectal cancer screens that is adequate to incentivize physicians to perform colorectal cancer screens. It would base this incentive on a national colorectal cancer screening goal established by the Secretary of the Department of Health and Human Services.
• The bill would also require the Secretary to establish a national minimum standard for basic knowledge, training, continuing education and documentation for physicians and facilities. A physician would not be permitted to receive the preventive services modifier if he or she did not meet this standard.
State Interventions to Increase Screening
• The legislation would also support state-level interventions to increase colorectal cancer screening. The legislation authorizes grants to states for colorectal cancer programs that include: screening to high risk individuals; case management and referrals for treatment; follow up and care for individuals screened; health professional education, training, and skills; and public information and education programs.
Information on What Works
• Finally, the legislation gathers information on best practices in incentivizing colorectal cancer screening. The bill requires reporting on screening rates and interventions in Medicare Advantage and commissions a study by the Secretary of HHS on levels of coinsurance for screening tests under private plans.
• More than 50,000 Americans will die from colon cancer this year alone. Ninety percent of these cases might have been prevented. We cannot afford to wait another moment before doing something to eliminate these and other barriers that are standing in the way of preventing colon cancer.
• Therefore, I urge all of my colleagues to co-sponsor the Supporting Colorectal Examination and Education Now (SCREEN) Act and support its passage this year.
• I thank the Speaker and yield the floor.