<Medicare and Colorectal cancer>

March is National Colorectal Cancer Awareness Month! Colorectal cancer is preventable, treatable and beatable. Encourage your patients to get screened it could save their lives. By Marcia Pryce, MPH, CHES Centers for Medicare & Medicaid Services (CMS) Division of Medicare Operations (DMO) The goal of this national health observance is to increase awareness that colorectal cancer is largely preventable, treatable and beatable. In conjunction with National Colorectal Cancer Awareness Month, the Centers for Medicare & Medicaid Services (CMS) remind health care professionals that Medicare provides coverage for certain colorectal cancer screenings. Colorectal cancer affects both men and women of all racial and ethnic groups, and is most often found in people aged 50 years or older. And the risk for developing colorectal cancer increases with age. Medicare Covered Colorectal Cancer Screenings Medicare provides coverage of colorectal cancer screenings for the early detection of colorectal cancer. All Medicare beneficiaries age 50 and older are covered; however, when an individual is at high risk, there is no minimum age required to receive a screening colonoscopy or a barium enema rendered in place of the screening colonoscopy. An individual is considered to be at high risk for colorectal cancer if he or she has had colorectal cancer before or has a history of polyps, has a family member who has had colorectal cancer or a history of polyps, or has a personal history of inflammatory bowel disease, including Crohn’s Disease and ulcerative colititis. Coverage Information for 2007! Starting in January 2007, Medicare waived the requirement that beneficiaries meet the deductible for screening colonoscopy, sigmoidoscopy, or barium enema (as an alternative to colonoscopy or sigmoidoscopy). In addition, the coinsurance for colonoscopy and sigmoidoscopy is now 25% when performed in ambulatory surgical centers and non-outpatient prospective payment system hospital outpatient departments. Medicare provides coverage for the following colorectal cancer screenings subject to certain coverage, frequency, and payment limitations: · Fecal Occult Blood Test (FOBT) · Colonoscopy · Sigmoidoscopy · Barium Enema (as an alternative to a covered screening flexible sigmoidoscopy or screening colonoscopy) Prevention Is Key! Colorectal cancer is the second leading cancer killer in the United States; however it doesn't have to be. Colorectal cancer is largely preventable through screening which can find precancerous polyps-abnormal growths in the colon or rectum-so that they can be removed before turning into cancer. Screening also helps find colorectal cancer at an early stage, when treatment can often lead to a cure. CMS needs your help to ensure that eligible Medicare patients get screened for colorectal cancer. Talk with your Medicare patients and their caregivers about the importance of being screened and those patients who were screened before entering Medicare should be encouraged to continue with screening at clinically appropriate intervals. CMS Needs Your Help CMS needs your help to get the word out to your Medicare patients and their caregivers about the benefits of colorectal cancer screening. We hope that you will encourage your eligible Medicare patients to take advantage of this potentially life saving benefit. For More Information CMS has developed a variety of educational products and resources to help health care professionals and their staff become familiar with coverage, coding, billing, and reimbursement for all preventive services covered by Medicare. • The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for Medicare Learning Network (MLN) preventive services educational products and resources for health care professionals and their staff. http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp#TopOfPage • Cancer Screenings Brochure ~ This tri-fold brochure provides health care professionals with an overview of cancer screenings covered by Medicare, including colorectal cancer screening services. ttp://www.cms.hhs.gov/MLNProducts/downloads/Cancer_Screening.pdf For information to share with your Medicare patients, visit http://www.medicare.gov


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