(Extensions of Remarks - October 13, 2011)

Text available as:

Formatting necessary for an accurate reading of this text may be shown by tags (e.g., <DELETED> or <BOLD>) or may be missing from this TXT display. For complete and accurate display of this text, see the PDF.


[Extensions of Remarks]
[Page E1863]
From the Congressional Record Online through the Government Publishing Office []

                     SCREEN ACT FOR 112TH CONGRESS


                          HON. RICHARD E. NEAL

                            of massachusetts

                    in the house of representatives

                       Thursday, October 13, 2011

  Mr. NEAL. Mr. 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 urge all of my colleagues to support this important 
  The statistics surrounding colon cancer are startling. Colon cancer 
is the number two cancer killer in the United States for both men and 
women. (CDC Colorectal Cancer Vital Signs; July 2011)
  Over 50,000 people will die this year from this disease according to 
the American Cancer Society (2010 Fact & Figures).
  These deaths become more tragic when one considers that colorectal 
cancer is highly preventable with appropriate screening. According to 
the American Cancer Society (2010 Facts & Figures), the 5 year survival 
rate is 90% for those diagnosed at an early stage; however, less than 
40% of the cases are diagnosed at that stage.
  During colorectal cancer screening by colonoscopy, pre-cancerous 
polyps are removed during the same encounter, thus preventing cancer 
from developing, as opposed to other cancer screenings where early 
detection is the goal. That is one reason why the U.S. Preventive 
Services Task Force provides an ``A'' rating for CRC screenings.
  The CDC ``colorectal cancer control program'' screening target rate 
is 80%. The American Cancer Society and other patient advocacy groups 
have a target rate of 75%. Unfortunately, only half of the Medicare 
population is being screened, despite the availability of a Medicare 
colon cancer screening benefit. According to CMS and American Cancer 
Society (March 2011), Medicare claims indicate that only 52-58% of 
beneficiaries have had any colorectal cancer test and there is 
``clearly an opportunity to improve colorectal cancer screening rates 
in the Medicare population.''
  The latest findings by the American Cancer Society confirm that 
screening rates among the Medicare population continue to be in this 
50th percentile range, with screening rates among minority populations 
that are especially low among Medicare-aged beneficiaries.
  The CDC concludes that 1,000 additional colorectal cancer deaths will 
be prevented each year if screening rates reached 70.5%. (CDC 
Colorectal Cancer Vital Signs; July 2011).
  In addition to saving lives, colorectal cancer screening has been 
demonstrated to save Medicare long-term costs as noted by the New 
England Journal of Medicine in a recent article (Feb. 2008).
  The direct costs of treating colorectal cancer in 2010 reached $4 
billion. (CDC Colorectal Cancer Vital Signs; July 2011)
  I am pleased that Congress took steps to improve access to life-
saving colon cancer screening when it passed the Patient Protection and 
Affordable Care Act (PPACA) in March 2010.
  While Congress has made tremendous strides in increasing colorectal 
cancer utilization rates in PPACA, this bill will further make live 
saving screenings more accessible to Medicare beneficiaries.
  Currently, Medicare waives cost-sharing for any colorectal cancer 
screening recommended by the U.S. Preventive Services Task Force. 
However, should the beneficiary have a precancerous polyp removed, the 
procedure is no longer considered a ``screening'' for Medicare coding 
  The unintended consequence of this is that the beneficiary is 
obligated to pay the Medicare coinsurance because the procedure is no 
longer a ``screening.'' However, the purpose of the screening is to 
find and remove precancerous polyps.
  The SCREEN Act waives all Medicare beneficiary cost-sharing for 
colorectal cancer screenings that become ``therapeutic'' or diagnostic 
  The legislation also resolves this unintended consequence for 
beneficiaries participating in health insurance exchanges beginning in 
  The SCREEN Act also provides incentives for Medicare providers to 
participate in nationally recognized quality improvement registries so 
that our Medicare beneficiaries are in fact receiving the quality 
screening they deserve.
  Lastly, the SCREEN Act removes barriers to screening rates by 
allowing a Medicare beneficiary to sit down and discuss the importance 
of the procedure before seeing the provider for the first time right 
before procedure. The federal government and colorectal cancer patient 
advocacy groups have concluded that the ``fear of the procedure'' is a 
major impediment to increasing colorectal cancer screening rates.
  Promoting access to colorectal cancer screening is good policy. It 
will save lives and reduce costs to families and the health care 
system. Please join with me in the fight against colorectal cancer by 
cosponsoring this legislation.