Full coverage for screening colonoscopy and certain other types of preventive procedures became official and implemented September 23, 2010. Under the new law, insurers or health insurance companies can no longer impose cost-sharing requirements for preventive services or medical care. Insurers are now required to cover the entire cost of certain preventive medical procedures, including screening colonoscopy, under one of several provisions pursuant to the Affordable Care Act (“ACA”), effective September 23rd.
The American Society for Gastrointestinal Endoscopy and the Colorectal Cancer Coalition are praising the new rule that requires health insurance plans or carriers to cover colorectal cancer screenings and other types of preventive services without imposing cost-sharing requirements on patients, for example, patients or health insurance plan consumer no longer have to pay “co-pays.” But, the groups note in a press release that adults who choose to undergo screening colonoscopies “may be unfairly penalized” because the law allows health insurers to impose cost-sharing requirements if precancerous polyps are removed during colonoscopy screenings. “We call upon health plans and insurers to fully eliminate the cost burden of colonoscopy colorectal cancer screening by waiving cost-sharing for the screening portion of colonoscopies in the event that they turn therapeutic and a polyp is removed,” says ASGE President M. Brian Fennerty, MD, FASGE.
Under the Affordable Care Act, the rule waiving patient cost-sharing for preventive services only applies if the care is administered by in-network providers. There are other such details to the new provisions that can be found on the federal government’s website (link provided below). Preventive procedures and screenings eligible under the rule are determined by the U.S. Preventive Services Task Force and the Health Resources and Services Administration.
Gray and White Law has a team of lawyers with decades of experience and has helped many Kentucky families whose loved ones may have suffered from injuries that could have been prevented or injuries that resulted from negligent medical care provided by a hospital, doctor, specialist, nurse or orderly. Please contact us today for a FREE CONSULTATION.
Additional information on the ACA provisions effective September 23, 2010 is available at: www.healthcare.gov, a federal government website managed by the U.S. Department of Health & Human Services.