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 »

Although Medicare pays for colorectal cancer screening, not all older people enrolled in Medicare are screened.

Reviewing published medical literature, a task group from the National Colorectal Cancer Roundtable found research identifying both barriers to screening and factors that made it easier.

The most frequently mentioned barrier related to healthcare providers was lack of a doctor’s recommendation.  Having a usual source of health care facilitated getting screened. Read the rest of this entry »

Briefly

• The Colorectal Cancer Association of Canada is sponsoring a contest for print and video ads that raise awareness of colorectal cancer.
• Clinical trials at the NIH Clinical Center in Bethesda, MD are an option for cutting-edge treatment at no cost.
• When co-pays are raised for Medicare, the elderly make fewer outpatient visits but are hospitalized more often and stay in the hospital longer.

Read the rest of this entry »