By Melissa Patrick
Kentucky Health News
FRANKFORT, Ky. – Two health-related bills, one to remove a financial barrier for colorectal cancer screenings and the other to allow consumers to synchronize prescriptions so they can get all of their medications on the same day, passed the state Senate Feb. 19.
Senate Bill 61, sponsored by Sen. Ralph Alvarado, R-Winchester, would clarify that a fecal test to screen for colon cancer, and any follow-up colonoscopy, are preventive measures that federal health reform require to be covered by insurance. It went to the House on a vote of 31-3.
"The purpose of this bill is to identify and correct ongoing discrepancies in the coding and billing portion of this screening and prevention continuum," said Alvarado, who is a physician.
The two primary ways to screen for colon cancer are colonoscopy or a non-invasive fecal blood test.
This bill was prompted because patients are being charged for a diagnostic procedure instead of a preventive one if they do a non-invasive fecal test that comes back positive, and then get a follow-up colonoscopy. The non-invasive fecal test is coded as a preventive screening, which is covered by insurance, but the colonoscopy is coded as a diagnostic procedure, which comes with a hefty price-tag, sometimes upwards of $1,000, Alvarado said.
Patients are also being charged for a diagnostic procedure if lesions are removed during the screening process, which is standard procedure to do so, since the patient would otherwise have to return for a second colonoscopy to remove them.
This is ironic, Alvarado said in a news release, because if the patient had chosen the more expensive and invasive colonoscopy initially, the insurance company would have paid for it.
This is a "barrier to screening," he said, in a state that leads the nation in colorectal cancer and until recently led the nation in deaths caused by it.
A sister bill, House Bill 69, sponsored by Rep. Tom Burch, D-Louisville, passed the House Feb. 9 and was assigned to the Senate Health and Welfare committee Feb. 12.
By a 34-0 vote, the Senate passed SB 44, sponsored by Sen. Julie Raque Adams, R-Louisville. It would allow patients with multiple prescriptions, in consultation with their health care provider and their pharmacist, to synchronize them so that they may be picked up from the pharmacy at the same time.
"This bill will allow patients to refill and pick up their prescribed medications for chronic conditions on the same day of the month instead of making multiple trips to the pharmacy," Adams said.
"This bill is not just about convenience," Adams said, but also helps make sure patients take their medication, "improving health outcomes and lowering health care cost overall." She cited a study that found patients who participated in a med-synchronization program at their pharmacy were 30 percent more likely to take their medicine as prescribed.
Some are concerned about the front-end cost of this program, "but fail to see the potential cost savings to the health care system overall," Adams said, saying a Medicare Part D cost-benefit analysis found there was an estimated savings of $1.8 billion to the system, and also showed improved medication adherence.
A sister bill, House Bill 140, sponsored by Rep. Addia Wuchner, R-Florence, was assigned to the House Banking and Insurance Committee on Jan. 9.