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Medicare Covers Colonoscopy After Noninvasive Screening Test

November 3, 2022

Washington, D.C. - National nonprofit organizations Fight Colorectal Cancer (Fight CRC), American Cancer Society Cancer Action Network (ACS CAN), and the American Gastroenterological Association (AGA), alongside colorectal cancer (CRC) advocates, celebrate as Medicare beneficiaries will no longer face out-of-pocket costs for a necessary colonoscopy after a positive noninvasive screening test. The Centers for Medicare and Medicaid Services (CMS) finalized the proposed rule earlier this week.  Additionally, the rule will lower the minimum age of colorectal cancer screening to 45, consistent with the 2018 American Cancer Society screening guidelines and the 2021 United States Preventive Services Task Force colorectal cancer screening recommendations.

Colorectal cancer is the second-most common cause of cancer deaths in the U.S. among men and women combined, and it is one of the few cancers that can be prevented through screening. The final CMS rule is an important step toward reaching the goals laid out in the President’s Cancer Moonshot initiative by reducing the screening barriers for Medicare beneficiaries.

Noninvasive screening tests, such as FIT or Cologuard®, are great options for average-risk patients to complete CRC screenings. But for those who receive a positive result, screening is not complete until they undergo a colonoscopy. Ensuring that cost is not a barrier will help increase access to CRC screening and ultimately save lives.

“We are grateful that CMS took this important step to help increase access to colorectal cancer screening and align with guidance released earlier this year by the Departments of Health and Human Services, Treasury and Labor,” said Anjee Davis, Fight CRC President. “For years Fight CRC – along with ACS CAN, AGA, and countless other colorectal cancer advocates – have advocated for this necessary policy change. This is an important win for patients.”

“ACS CAN is thrilled to see CMS finalize its rule to help increase access to colonoscopies by eliminating cost sharing after a positive noninvasive screening test and lowering the screening age from 50 to 45, in line with the 2018 American Cancer Society screening guidelines,” said Lisa Lacasse, President of ACS CAN. “We know anticipated costs can result in delayed or skipped procedures with potentially life-threatening consequences, especially for those on fixed incomes. Removing this barrier will save lives and help end cancer as we know it.”

“This action by CMS will save lives and guarantee beneficiaries have coverage of a complete screening,” said John Caruthers, MD, President of the AGA. “We applaud the agency as this is an important step in improving screening adherence, lowering incidence and mortality, and improving health equity.”

For more information or to find the nearest screening options visit Fight CRC at FightCRC.org, the American Cancer Society at cancer.org/colon, or AGA at gastro.org.  

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Media Contacts

Emily Burr
Director, Media Advocacy
Washington, D.C.
Alissa Crispino
VP, Advocacy Communications and Policy
Washington, D.C.