In a nutshell:

A brief look this week at

• Blood sugar and colorectal cancer risk
• Outcomes for people with defective mismatch repair on oxaliplatin
• Medicare’s preventive services

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Obese people on Medicare  now have the opportunity to have regular weight loss counseling paid for when offered by a primary care provider.  Since this is considered prevention, there is no co-pay.

On November 29, the Centers for Medicare and Medicaid Services announced that there was enough evidence that intensive behavioral counseling was reasonable and necessary to prevent disease or disability and that Medicare beneficiaries were entitled to coverage as a preventive service.

This is particularly good news for people trying to prevent colon or rectal cancer since studies have consistently found a link between body mass index (fatness) and colorectal cancer, including the World  Cancer Research Foundation which included BMI and colorectal cancer in their 2007 comprehensive analysis reported in  Food, Nutrition, Physical Activity and the Prevention of Cancer. Read the rest of this entry »

After a normal colonoscopy when no polyps are found, guidelines call for a repeat test in 10 years.

However, almost half of Medicare patients with a negative colonoscopy got another exam within 7 years, and for one in four there was no clear evidence that they needed one.

Because colonoscopies have real risks and are expensive, over-testing can be both dangerous and costly. Given limited numbers of physicians who do colonoscopies, unecessary procedures add to long waiting lists for screening and for necessary follow-up exams.

Although Medicare regulations call for reimbursement only after 10 years in cases where the first procedure didn’t find a problem, payments are being made for earlier exams.  In fact, Medicare denied payment for only 2 percent of colonoscopies for which there was no clear indication of need. Read the rest of this entry »

Colorectal cancer screening programs targeted at the pre-Medicare population (ages 54-64) could pay for themselves in avoided future Medicare expenditures, according to a study released last week at the American College of Gastroenterology’s annual meeting.

Using a computer simulation program, researchers estimated the total lifetime costs for screening and any subsequent treatment of colorectal cancer in people over age 50, using three different kinds of testing (fecal occult blood test, or FOBT; a mix of FOBT and colonoscopy; or colonoscopy alone). Read the rest of this entry »

This week the federal government began mailing $250 checks to Medicare Part D enrollees who have reached the doughnut hole where Part D no longer covers prescription drugs.

These checks are sent automatically to seniors when 2010 prescription costs reach the coverage gap.

It is not necessary to apply for the check!

But scam artists are already at work, contacting  seniors and other Medicare beneficiaries asking for social security numbers, bank accounts, and pretending to help them apply for the $250 rebates. Read the rest of this entry »