[Congressional Record Volume 155, Number 129 (Monday, September 14, 2009)]
[Extensions of Remarks]
[Pages E2256-E2257]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     INTRODUCTION OF THE SCREEN ACT

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                          HON. RICHARD E. NEAL

                            of massachusetts

                    in the house of representatives

                       Monday, September 14, 2009

  Mr. NEAL of Massachusetts. Madam Speaker, 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

[[Page E2257]]

urge all of my colleagues to support this important legislation.


                               Background

  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.


                               Conclusion

  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.

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