In a huge win for patients, Medicare will begin covering colonoscopies after a positive noninvasive stool test starting in 2023. Medicare was previously the only insurer who did not cover this critical prevention procedure.
This change comes after a year of advocacy led by AGA – including multiple meetings with senior officials at HHS and legislative pressure by members across the country.
“Cost-sharing is a well-recognized barrier to screening and has resulted in disparities. Patients can now engage in CRC screening program and be confident that they will not face unexpected cost-sharing for colonoscopy after a positive noninvasive screening test,” said David Lieberman, MD, AGAF, who met with Centers for Medicare & Medicaid Services officials multiple times to push this policy forward. “AGA knows that increased participation in screening will further reduce the burden of colorectal cancer.”
“This is a win for all patients and should elevate our nation’s screening rates while lowering the overall cancer burden, saving lives. Importantly, the CMS proposed rule changes will lessen colorectal cancer disparities eliminating a financial burden for many patients,” said AGA president John Carethers, MD, AGAF, who met with CMS in early July to advocate for this change.
Thank you to everyone in the GI community who advocated for this important change!
CMS announced the coverage change as part of the 2023 Medicare proposed rule, which was released July 7, 2022. The rule must be finalized this fall before taking effect Jan. 2, 2023.
