Colonoscopy Reimbursement for Low-Income Residents Considered by Wyoming
Posted by Dusty Weaver on February 28th, 2007
Low-income Wyoming residents would be eligible for reimbursement under a bill working its way through the state legislature, The Wyoming Cancer Control Act (S 131) would authorize the state to provide a colonoscopy reimbursement to people over the age of 50 who are at or under 250 percent of the poverty level and who haven’t had a colonoscopy within the past ten years.
The Associated Press reported the bill’s sponsor Sen. Charles Scott, R-Casper, as saying:
“A colonoscopy is a well-proven technique for preventing colorectal cancer. If they find a polyp (during the screening process) they take it out to prevent cancer from developing and the prevention rate is well over 90 percent… It is often poorly covered by insurance. And unfortunately the risk of getting a high bill is becoming an obstacle to people getting a colonoscopy.”
As approved by the Senate the act would cost Wyoming approximately $4.3 million of which about $3.9 million was slated for the colonoscopy voucher program. The House Labor Committee, chaired by Rep. Jack Landon Jr., R-Sheridan, amended the bill to limit the contribution for the procedure to $1,500. Then the House Appropriations Committee, chaired by Rep. Frank Philp, R-Shoshoni, reduced the proposal’s colonoscopy funding to only $1.2 million.
Sen. Scott estimated that colonoscopies cost between $1,000 and $4,500, in situations where polyps need to be removed. Rep. Landon said the $1,500 voucher would cover most routine colonoscopies. According to the AP report the funding cut “was based on information the state Health Department obtained from a similar program in Colorado.” It quoted Rep. Philp as saying “It wasn’t like we were just giving it a haircut for the heck of it. We had the numbers from the Health Department to go along with our decision.” Sen. Scott responded by saying the House Appropriations Committee took too much.
Tuesday the Senate defeated the bill as amended by the House which was to be expected given the overwhelming support the Senate gave its original bill. Latter that day the bill was amended on the floor of the House to say that the state would provide reimbursement “at the rate paid under the Wyoming Medical Assistance and Services Act for colonoscopies including polyp removal.” The bill now goes to a conference committee which will try to work out differences between the two versions of the bill.
According to a Casper Star Tribune article, Wyoming Comprehensive Cancer Control program manager Kim Rogers said:
“The average cost of treatment for an early detection of colorectal cancer is $30,000. But at the late stage it runs about $120,000, so we’re looking at a big cost savings for the state if we’re able to detect things earlier.”
It is important to remember that colon and rectal cancer can not only be detected in early, more treatable stages but that it can be prevented with the removal of polyps before they become cancerous thus resulting in even greater cost savings.
An interesting section of S 131 would require the Health Department to obtain colonoscopy provided by a sealed, competitive bid process. Voucher users would be required to go to these providers for colonoscopies.
Also covered is what happens if a cancer is found during a colonoscopy performed under the act. If the person is not covered by Medicaid and is without health insurance the Health Department is “authorized to pay for the treatment needed for that individual.” The patient pays the first $10,000 unless this is waved by the department with the maximum paid by the department of $50,000 for any one case.
