113/s/608/Statement on introduction

Mr. President, I rise today to introduce the Supporting Colorectal Examination and Education Now, SCREEN, Act. This legislation promotes access to colon cancer screenings in an effort to help prevent colorectal cancer, save lives, and reduce costs for families, the Medicare program, and the health care system. I strongly urge my colleagues to support this critical piece of legislation.

Colorectal cancer affects far too many Americans. The rate of colon cancer deaths is shocking—taking the lives of over 50,000 people this year alone, according to the American Cancer Society.

Fortunately, colorectal cancer is highly preventable with screening, and colon cancer screening tests rank among the most effective preventive screenings available. A recent study in the New England Journal of Medicine found that removal of precancerous polyps during a screening colonoscopy may reduce colon cancer deaths by over 50 percent. Early detection and intervention are key to preventing colon cancer. Colonoscopy screenings are different from other types of preventive or screening services because pre-cancerous polyps found during a screening are removed during the same visit, thus preventing a potential cancer from developing and helping to ensure detection, intervention, and prevention.

Congress recognized the value of colon cancer screenings and, through bipartisan legislation that I authored in 1998, established a Medicate benefit for screening. The problem is that only half of individuals coveted by the Medicare program receive a screening colonoscopy, even though a Medicate colorectal cancer screening benefit is available. According to the Centers for Medicare & Medicaid Services, CMS, Medicare claims show that only 52 percent of beneficiaries have had a colorectal cancer screening test. Many barriers account for this, including patient education on screenings and operational issues within the Medicare program, but colorectal cancer has become too widespread and we have reached the time to take action to promote prevention and save lives. Ensuring that individuals receive colorectal cancer screening tests is critical to this goal.

In addition, detection and intervention through proper colonoscopy screening should reduce costs to the Medicare program and health care system overall. Once colon cancer develops, the direct costs of treating colon cancer are starting—reaching $4 billion in 2010. A recent study published in the New England Journal of Medicine concluded that colorectal cancer screening has been shown to reduce Medicare long-term costs.

Congress must help promote access to colorectal cancer screenings and help increase the number of persons receiving these life-saving screening tests. The SCREEN Act takes many steps to increase the rate of colorectal cancer screenings and help prevent colon cancer, while also reducing Medicare costs.

The SCREEN Act first waives cost sharing for Medicare beneficiaries receiving colorectal cancer screenings where precancerous polyps are removed during the visit. Currently, Medicare waives cost-sharing for any colorectal cancer screening recommended by the U.S. Preventive Services Task Force, USPSTF. Colorectal cancer screens have a grade “A” recommendation by USPSTF. However, if the doctor finds and removes a precancerous polyp during the visit, the procedure is no longer considered a “screening” for Medicare purposes--and the beneficiary would be forced to pay the Medicare coinsurance. In February 2013, the Administration announced that private insurers participating in State-based health insurance exchanges must waive all cost sharing for colon cancers screenings where a polyp is removed. This bill promotes a similar policy by waiving Medicare cost sharing for diagnostic and screening colorectal cancer tests.

Additionally, the SCREEN Act extends Medicare coverage to include an office visit or consultation so that a Medicare beneficiary may sit down and discuss the screening with a doctor prior to the colonoscopy procedures. One of the major barriers to increasing colorectal cancer screening rates is a patient's lack of knowledge and the “fear of the procedure.” This pre-procedure visit is not only good clinical practice but also would help increase patient utilization of colorectal cancer screening. This visit allows the individual to ask questions about the procedure, assures selection of the proper screening test, and increases beneficiary education and test preparation. There is no reason for a Medicare beneficiary to be seeing his or her physician for the first time only just before being sedated for the procedure.

The SCREEN Act also provides incentives for Medicare providers to participate in nationally recognized quality improvement registries so that our Medicare beneficiaries are receiving the quality screening they deserve. Congress and other organizations can look to the SCREEN Act as a model for Medicare reimbursement reform as the bill reimburses providers in a budget neutral manner based on the quality of the procedure and not volume of services.

Promoting access to colorectal cancer screening will help ensure detection and intervention of this highly preventable disease and reduce costs to the health care system. I ask my colleagues to join in support of this fight to end colorectal cancer by cosponsoring this important legislation.