Article preview from "The Gray Sheet" - July 12, 2010
Medicare beneficiaries would no longer have to pay coinsurance for certain colorectal cancer screening tests under CMS' 2011 Outpatient Prospective Payment System proposed rule.
Outpatient Payment Draft Supports Preventive Health Care Screening Tests
By Monica Hogan
Medicare beneficiaries would no longer have to pay coinsurance for certain colorectal cancer screening tests under CMS' 2011 Outpatient Prospective Payment System proposed rule.
The July 2 document also proposes that the deductible, though not coinsurance, be waived for all surgeries done on the same day as a planned screening colonoscopy or flexible sigmoidoscopy. CMS explains that it will consider such surgeries as being connected with the screening procedure, reasoning that "it would be very rare for an unrelated surgery to occur on the same date as one of these scheduled screening tests."
The proposals are intended to implement provisions of the Patient Protection and Affordable Care Act, which grants Medicare beneficiaries a free annual wellness visit starting Jan. 1, 2011. The health care reform law also specifically asks CMS to waive the Medicare beneficiary deductible for colorectal cancer screening tests that become diagnostic.
The proposed rule, which addresses procedures performed on an outpatient basis at hospitals and ambulatory surgical centers, would also waive the coinsurance and deductible for ultrasound screening for abdominal aortic aneurysm, screening Pap tests, and bone mass measurement with X-ray absorptiometry or computed tomography.
Additional services that would be included as part of the annual wellness visits are described in the 2011 Medicare physician fee schedule draft released June 25
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