[Congressional Record (Bound Edition), Volume 151 (2005), Part 20]
[Senate]
[Pages 27067-27068]
[From the U.S. Government Publishing Office, www.gpo.gov]




                    COLON CANCER SCREEN FOR LIFE ACT

  Mr. NELSON of Nebraska. Mr. President, I rise in support of the Colon 
Cancer Screen for Life Act, S. 1010. Some of its provisions were 
included in an

[[Page 27068]]

amendment included in the reconciliation package. This legislation will 
increase the likelihood that Medicare beneficiaries will receive a 
colonoscopy screening examination which is proven to be the most 
effective way to detect and treat colorectal cancer.
  Colorectal cancer is the No. 2 cancer killer in the United States 
today. This year, according to the American Cancer Society, 
approximately 145,000 new cases will be diagnosed and 56,000 Americans 
will die from colon cancer. We have the power to change these sobering 
statistics by increasing access to this lifesaving procedure. Although 
Congress passed a colonoscopy screening benefit for Medicare 
beneficiaries back in 1997, the percentage of seniors receiving a 
colonoscopy reportedly has increased by only an estimated 1 percent. A 
recent UCLA study, as discussed in an October 11 Wall Street Journal 
article, documents the continuing underutilization of screening 
colonoscopies. It points out that colorectal cancer screening rates 
still lag far behind those for cervical, breast and prostate cancer. As 
the Wall Street Journal article concludes, ``The results were 
particularly disturbing because `we could eliminate this disease if 
America had the will,''' as the study's lead author noted.
  One reason for the underutilization of colonoscopy screening in the 
Medicare population is rapidly declining rates of reimbursement for the 
procedure. Medicare reimbursement for colonoscopies performed in the 
outpatient setting has dropped by nearly one-third from the initial 
1998 reimbursement rates. In the majority of States today, Medicaid 
payment rates actually exceed Medicare reimbursement for colonoscopy. 
This fact alone underscores the Medicare reimbursement problem is real. 
This legislation increases Medicare reimbursement for colorectal 
cancer-related procedures to assure more equitable reimbursement for 
physicians who absorb significant costs in providing these valuable 
services.
  Another reason for this underutilization is that Medicare currently 
does not pay for a physician office visit prior to a screening 
colonoscopy, although it does pay for a physician office visit prior to 
a diagnostic colonoscopy. The procedures are identical--both involve 
the same amount of risk, so there is simply no reason why Medicare 
would pay for an office visit prior to one procedure and not the other. 
Because Medicare does not pay for this necessary office visit, many 
physicians must provide them for free. This amendment would fix this 
discrepancy by providing Medicare coverage for a preoperative visit or 
consultation prior to a screening colonoscopy, as it does for a 
diagnostic colonoscopy.
  Every year, thousands of Americans needlessly die from colorectal 
cancer. We have the means to change this and we should do so. I 
appreciate our Senate colleagues joining in support of this important 
legislation.

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