Unexpected costs for colonoscopies under the ACA

A study that came out a few months ago showed that under the Affordable Care Act coverage, many people could be billed for a colonoscopy that should have been covered because they had a polyp removed during the procedure.That was because the ACA was unclear if this was covered.

But the government clarified this week that the ACA does cover polyp removal during screening. This is great news, as polyp removal can prevent colon cancer.

See the FAQ about the ACA here.

Kentucky Governor Announces Screening Funds

Gov. Beshear Announces Funding For Colon Cancer Screening

Posted: Jan 3, 2013 9:58 AM Channel 18 Lexington

Ten local health departments across the state will receive grants to expand colon cancer screening services, Governor Steve Beshear announced Thursday.

Gov. Beshear sought funding for the program in last year's biennial budget proposal in an effort to reduce colon cancer incidence and mortality rate in Kentucky. According to data from the Kentucky Cancer Registry at the University of Kentucky, about 2,600 new cases of colon cancer will be diagnosed in Kentucky each year and nearly 900 people will die.

The screening program is intended for low income, uninsured Kentuckians between the ages of 50 and 64.

"Colorectal cancer is the second leading cancer killer in the United States, and Kentucky's incidence rate is higher than the national average," said Gov. Beshear. "If everybody age 50 or older had regular screening tests, at least one-third of deaths from this cancer could be avoided. This initiative will help more Kentuckians access those crucial screening tests."

The Kentucky Department for Public Health worked with the Kentucky Cancer Foundation and the Kentucky Colon Cancer Screening Advisory committee to develop the grant program, utilizing $500,000 in state funds earmarked by the Kentucky General Assembly for colon cancer outreach and education, patient navigation and colon cancer screening services.

The Kentucky Cancer Foundation, which helps fund selected portions of the state's overall Kentucky Cancer Action Plan, will provide a like amount of matching funds for the colon cancer screening program each year.

"The private-public partnership in funding our state cancer action plan is the first of its kind nationally," said Dr. Whitney Jones, chairman of the Kentucky Cancer Foundation. "We look forward to completing this specific match and expanding services statewide in the future. We appreciate the investments in community health and wellness and the forward thinking of Governor Beshear and the legislature."

Public health officials stress the impact of the disease on the state and said it is important to partner with various agencies to reduce the disease burden in the commonwealth.

"Colon cancer is a very serious health concern that impacts too many Kentuckians," said Dr. Stephanie Mayfield, public health commissioner. "Like many diseases, early detection is integral to successful treatment of the disease. Colon cancer screening not only helps us detect colon cancer early, but it may also prevent cancer by removing polyps before cancer develops."

Over the next two years, grants will be awarded to local health departments, which have formed partnerships with community health care providers to offer services. Awardees include:

  • Barren River District Health Department
  • Calloway County Health Department
  • Christian County Health Department
  • Fayette County Health Department
  • Floyd County Health Department
  • Greenup County Health Department
  • Jessamine County Health Department
  • Lake Cumberland District Health Department
  • Louisville Metro Health Department
  • Pike County Health Department

According to the Centers for Disease Control and Prevention, the five-year survival rate for colon cancer is 90 percent when found and treated early, underscoring the need for preventive health exams like the fecal immunochemical test or colonoscopy. Screenings detect any abnormalities or early signs of cancer, like polyps in the colon. When detected early, polyps can be easily removed during a colonoscopy before they develop into cancer.

Both men and women are at risk of developing colorectal cancer and should be screened. However, data from the Kentucky Behavioral Risk Factor Surveillance System shows that only 63 percent of Kentuckians who should have screening tests have had them. Kentucky also has a higher than average population with increased risk of colon cancer due to higher rates of obesity, diets high in fat and lack of regular exercise.

"Screening and early detection help to prevent colon cancer and save lives," said Dr. Mayfield. "If you are 50 or older or have a history of colon cancer in your family, get screened. It's the best way to ensure your future health and well-being."

According to DPH, screening is particularly important to the prevention of colon cancer because the disease can have no symptoms. When symptoms do develop at a later stage of the cancer, they may include blood in the stool, cramping in the abdomen, changes in bowel habits and unexplained weight loss. Individual risk for colorectal cancer may be higher than average if you or a close relative have had colorectal polyps or colorectal cancer, or if you have inflammatory bowel disease.

The U.S. Preventive Services Task Force and American Cancer Society recommend colorectal cancer screening for men and women aged 50-75. For African-Americans, screening should begin earlier, at age 45.

The Kentucky Colon Cancer Screening Program uses high-sensitivity fecal immunochemical testing (FIT) and colonoscopy to test for the disease. Talk to your doctor or contact a local health department for more information about which test or tests are right for you. Most insurance plans, Medicaid and Medicare help cover the cost.
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