Medicare beneficiaries don’t have to pay for screening colonoscopies. However, if a polyp is found and removed, the procedure is coded as a diagnostic procedure, and the patient is required to pay coinsurance. CMS’ proposal, which would go into effect Jan. 1, 2020, doesn’t fix the issue of patients paying coinsurance — instead, it shifts the burden to providers, the AGA said.
Additionally, the AGA told CMS that beneficiaries should not be penalized for the agency’s misinterpretation of the Affordable Care Act, and for CMS to follow the Obama administration’s guidance to commercial insurers that it should not require beneficiaries to pay coinsurance when a screening colonoscopy becomes a diagnostic one.
Gastroenterologists can sign a letter to CMS urging them to change the rule. The form to fill out to send the letter can be found here.
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