ASCA Continues to Advocate for Full Coverage of Colonoscopies

Digital Debut

ASCA Continues to Advocate for Full Coverage of Colonoscopies

The organization supports the Colorectal Cancer Payment Fairness Act

BY DAVID OPONG-WADEE | MARCH 29, 2024

The Threat

As Colorectal Cancer Awareness Month comes to an end, colorectal cancer (CRC) remains a serious threat, ranking as the second deadliest cancer in the US after lung cancer. In 2023 alone, more than 153,000 people were diagnosed, and tragically, more than 52,000 succumbed to the disease.

The Hope

The good news is that many CRC cases are preventable through regular screenings. Colonoscopies are particularly effective. They allow for the removal of precancerous polyps during the procedure, significantly reducing cancer risk. Early detection, often achieved through colonoscopies, also leads to more successful treatment. In 2022, Amsurg ASCs performed more than 1 million colonoscopies on Medicare fee-for-service beneficiaries alone.

ASCA's Commitment

ASCA is dedicated to connecting patients with healthcare providers offering life-saving screenings like colonoscopies. To ensure wider access, ASCA actively tracks and advocates for relevant federal legislation.

Snapshot on Access

ASCA supports the Congressional Colorectal Cancer Caucus, led by Representatives Donald Payne Jr. (D-NJ) and Mark Green (R-TN). Since taking office in 2012, Representative Payne has remained a vocal advocate for early detection. His Removing Barriers to Colorectal Cancer Screening Act of 2020—cosponsored by Senator Sherrod Brown (D-OH) and signed into law in 2020—stands as a landmark achievement, eliminating copays for polyp removal or other necessary preventative procedures during colonoscopies. However, this action, particularly crucial for underserved communities, initially included a phase-in period delaying full coverage until 2030.

Alarmingly, CRC is rising sharply in younger adults. People born in the 1990s face double the colon cancer risk and quadruple the rectal cancer risk compared to those born in the 1950s. By 2030, CRC might be the top cancer killer for people under 50 because it is often diagnosed at a later, harder-to-treat stage. Moreover, CRC disparities persist on socioeconomic and racial lines. Black people have higher incidence and mortality rates compared to white people. Similarly, American Indian/Alaska Native populations experience higher rates, and screening rates lag among Latino/Hispanic Americans.

Recognizing the growing urgency tied to the shocking number of CRC diagnoses in people under age 50 and the skewed detection and death rates in underserved communities, ASCA strongly supports Representative Payne's latest initiative, the Colorectal Cancer Payment Fairness Act, which aims to accelerate full coverage for treatments received during screenings. This bill builds on the Removing Barriers to Colorectal Cancer Screening Act, accelerating full coverage for treatments during screenings to the end of 2024. This faster implementation would ensure Medicare beneficiaries have improved access to life-saving preventive care.

Why Choose ASCs for Colonoscopies?

With the rise of outpatient surgeries, efficient care models like ASCs become even more critical. ASCA advocates for equal out-of-pocket limits for Medicare Part B patients, regardless of whether they choose an ASC or a hospital outpatient setting. This simple change can save billions for Medicare while granting patients faster and fairer access to essential preventive procedures like colonoscopies.

Benefits of ASCs

  • Cost-Effective: ASCs offer significantly lower costs for colonoscopies, saving both patients and Medicare money.
  • Increased Access: Surgery centers can schedule more procedures per day, meaning faster access for patients.
  • Leading Expertise: Colonoscopies are the most common procedure performed in ASCs nationwide, showcasing their expertise.
  • Life-Saving Focus: ASCs play a vital role in facilitating early detection of colon cancer through colonoscopies.

The Fight Continues

While CRC remains a serious threat, there is hope. Regular screenings, particularly colonoscopies, are highly effective in prevention and early detection. Furthermore, the alarming rise in CRC among younger adults and disparities in underserved communities demands immediate action. Early detection remains critical.

ASCA is committed to increasing access to these life-saving measures and applauds the Removing Barriers to Colorectal Cancer Screening Act for eliminating copays for polyp removal and supports the Colorectal Cancer Payment Fairness Act for accelerating full coverage to improve access for Medicare beneficiaries by 2024.

Together, through increased awareness, improved access to screenings and efficient care models like ASCs, the tide on CRC can be turned. Please write David Opong-Wadee at dopongwadee@ascassociation.org with any questions.