S 1511 IS
111th CONGRESS
1st Session
S. 1511
To amend titles XVIII and XIX of the Social Security Act to improve awareness and access to colorectal cancer screening tests under the Medicare and Medicaid programs, and for other purposes.
IN THE SENATE OF THE UNITED STATES
July 23, 2009
Mr. CARDIN (for himself and Mr. GRAHAM) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend titles XVIII and XIX of the Social Security Act to improve awareness and access to colorectal cancer screening tests under the Medicare and Medicaid programs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘Supporting ColoRectal Examination and Education Now (SCREEN) Act of 2009’.
SEC. 2. FINDINGS AND SENSE OF CONGRESS.
(a) Findings- Congress makes the following findings:
(1) A majority of the deaths and costs associated with colorectal cancer, the second leading cause of cancer deaths in the United States, are avoidable through timely preventive screening, including colonoscopy.
(2) The United States Preventive Services Task Force provides its only grade ‘A’ recommendation of cancer screenings for colorectal interventions.
(3) Colorectal cancer screening test rates are far too low, with only 50 percent of recommended populations receiving colorectal cancer screening tests, and rates of such screening tests among minorities and those without insurance lag considerably.
(4) The colorectal cancer screening benefit under the Medicare Program under title XVIII of the Social Security Act is severely underutilized.
(5) Numerous barriers for patients, communities, and health care providers detrimentally affect the utilization of colorectal cancer screening tests. Such barriers include patient knowledge, coinsurance burdens, restrictions on Medicare coverage for an office visit prior to a screening colonoscopy, and reductions in Medicare reimbursement.
(b) Sense of Congress- It is the sense of Congress that--
(1) if legislation to provide health insurance coverage, public or private, to persons under the age of 65, is enacted, coverage of colorectal cancer screening tests and the provisions of this Act should be included as part of any basic benefit package required under such legislation; and
(2) Congress, Federal agencies, State and local governments, health care providers, and patient groups should make a concerted and sustained effort to increase the rate of colorectal cancer screening tests.
SEC. 3. COMMUNITY AND PATIENT INTERVENTIONS.
(a) Grant Program To Increase Colorectal Cancer Awareness, Screening, and Treatment-
(1) DEFINITIONS- In this subsection:
(A) COLORECTAL CANCER SCREENING TESTS- The term ‘colorectal cancer screening test’ has the meaning given such term in section 1861(pp)(1) of the Social Security Act (42 U.S.C. 1395x(pp)(1)).
(B) INDIAN TRIBE- The term ‘Indian tribe’ has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b).
(C) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention.
(D) STATE- The term ‘State’ means--
(2) GRANTS AUTHORIZED- The Secretary is authorized to make grants to States and Indian tribes for colorectal health programs. Such programs may include the following:
(A) Provide colorectal cancer screening tests, including colonoscopy, to individuals who are over 50 years of age or who are determined to be at high risk for such cancer.
(B) Provide case management and referrals for medical treatment for individuals who are provided colorectal cancer screening tests under the program.
(C) Programs to ensure that individuals who are provided colorectal cancer screening tests under the program receive the full continuum of follow up and cancer care, as appropriate.
(D) Activities to improve the education, training, and skills of health professionals in the detection and treatment of colorectal cancer.
(E) The development and dissemination of public information and education programs--
(i) for the detection and treatment of colorectal cancer; and
(ii) promoting the benefits of receiving colorectal cancer screening tests through the program.
(3) PRIORITY- In making grants under paragraph (2), the Secretary shall give priority to States and Indian tribes that will use grant funds to provide colorectal cancer screening tests to low-income individuals who lack adequate health insurance coverage with respect to such screening.
(4) EXISTING FUNDING AUTHORITY- The Secretary shall make a grant under this section under an existing funding authority.
(b) Beneficiary Reminders for Increasing Colorectal Cancer Screening Tests-
(1) DEFINITIONS- In this subsection:
(A) COLORECTAL CANCER SCREENING TESTS- The term ‘colorectal cancer screening test’ has the meaning given such term in section 1861(pp)(1) of the Social Security Act (42 U.S.C. 1395x(pp)(1)).
(B) MEDICARE BENEFICIARY- The term ‘Medicare beneficiary’ means an individual entitled to, or enrolled for, benefits under part A of title XVIII of the Social Security Act and enrolled for benefits under part B of such title.
(C) SECRETARY- The term ‘Secretary’ means the Secretary of Health and Human Services.
(2) ANNUAL NOTIFICATION UNDER THE MEDICARE PROGRAM- The Secretary shall establish a program under which all Medicare beneficiaries are notified annually about the coverage of colorectal cancer screening tests under the Medicare program under title XVIII of the Social Security Act. Under the program, such notification--
(A) may be provided through direct mail or direct electronic communications; and
(B) may accompany other information currently provided to such beneficiaries, including marketing materials or information provided to enrollees by Medicare Advantage organizations under section 1852(c)(1) of the Social Security Act (42 U.S.C. 1395w-22) and information provided by PDP sponsors under section 1860D-4(a)(1) of such Act (42 U.S.C. 1395w-104(a)(1)).
(3) STATE PLAN AMENDMENT UNDER MEDICAID-
(A) IN GENERAL- Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by section 5006(e)(2)(A) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5), is amended--
(i) in paragraph (72), by striking ‘and’ at the end;
(ii) in paragraph (73)(B), by striking the period at the end and inserting ‘; and’; and
(iii) by inserting after paragraph (73), the following new paragraph:
‘(74) if the State has elected to provide medical assistance described in section 1905(a)(13) and such assistance includes colorectal cancer screening tests, provide for the establishment of a program under which individuals at risk for colon cancer, including minorities who are identified as at high-risk for colon cancer, who are over an age that the Secretary determines appropriate (based on the recommendations of appropriate entities, including the United States Preventive Services Task Force and appropriate medical specialty societies) are provided a notification of the availability of medical assistance for colorectal cancer screening tests and a reminder regarding the benefits of such tests.’.
(B) EFFECTIVE DATE-
(i) IN GENERAL- Except as provided in clause (ii), the amendments made by this paragraph take effect on January 1, 2011.
(ii) EXTENSION OF EFFECTIVE DATE FOR STATE LAW AMENDMENT- In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by this paragraph, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.
SEC. 4. ELIMINATION OF COINSURANCE FOR COLORECTAL CANCER SCREENING TESTS.
Full Text of Legislation