Groups back bill asking Medicare to pay for CT colonography

Two Congressmen are sponsoring a bill that would provide Medicare coverage for computed tomography colonography, commonly known as virtual colonoscopy.

Reps. Danny Davis (D-Ill.) and Brad Wenstrup (R-Ohio) introduced the bill in the House of Representatives Tuesday. The bill, called the CT Colonography Screen for Colorectal Cancer Act (HR 1969) is intended to help address racial and ethnic disparities in screening and outcomes.

Latino Americans are more likely to die from colorectal cancer than those in many Central and South American countries. In addition, African Americans are far more likely to die from the disease than whites.

Data from federal agencies indicate that while virtual colonoscopy use is comparatively modest, primarily because of the lack of Medicare coverage, its use is growing more quickly among Latinos and African-Americans. However, both groups are less likely to be screened for colorectal cancer, and their cancers are found at a later stage than in whites.

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Medicare coverage for virtual colonoscopy – an American Cancer Society-recommended exam – can ease racial and ethnic disparities in colorectal cancer care.

Virtual colonoscopy is a minimally invasive exam to screen for cancer of the large intestine, commonly known as colon cancer. Unlike traditional colonoscopy, which requires a scope to be inserted into the rectum and advanced through the colon, virtual colonoscopy uses a CT scan to produce hundreds of cross-sectional images of abdominal organs. The images are combined and digitally manipulated to provide a detailed view of the inside of the colon and rectum.

Colorectal cancer care advocates, minority health care organizations and medical associations see the bill as an opportunity to help address racial and ethnic disparities in screening and outcomes. Previous studies in the U.S. and abroad have shown that use of the American Cancer Society-recommended exam raises screening rates and lowers costs.

However, Medicare currently does not cover the procedure for its beneficiaries.

“Medicare-covered access to virtual colonoscopy can attract many who would otherwise not be tested, allowing doctors to remove polyps before they become cancers,” says Carolyn R. Aldigé, CEO and founder of the Prevent Cancer Foundation.

“Medicare coverage of virtual colonoscopy can increase screening, help doctors find more cancers early and avoid cancers by removing polyps before they turn cancerous. This will save lives, particularly among those where screening rates are historically lower and outcomes not as good,” says Judy Yee, MD, chair of the American College of Radiology Colon Cancer Committee.

Nearly 40 states require insurance policies to cover virtual colonoscopy. Insurers who take part in federal exchanges are required by the Affordable Care Act (ACA) to cover the exam with no copay. UnitedHealthcare, CIGNA, Aetna, Anthem Blue Cross Blue Shield and others cover the test irrespective of ACA requirements.

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