Changes to colorectal cancer insurance coverage considered

The Banking, Commerce and Insurance Committee heard testimony Jan. 22 on a bill that would change provisions related to insurance coverage for colorectal cancer screening.

LB829, sponsored by Sen. Carol Blood of Bellevue, would add the concurrent removal of polyps, biopsy or both to coverage requirements for colorectal cancer screening by self-funded employee benefit insurance plans in Nebraska. Such plans are required to cover screening exams and laboratory tests for individuals who are at least 45 years old.

If a polyp is found and removed during a screening colonoscopy, however, the procedure instead may be deemed as diagnostic, Blood said, which could lead to hundreds of dollars in unexpected additional charges.

“This expense creates a barrier to the lifesaving screening for those who are most at risk for colorectal cancer,” she said. “This loophole could be the difference between life and death.”

John Trapp, a pulmonary and critical care physician, testified in support of the proposal on behalf of the Nebraska Medical Association. He said the bill would be a “positive step” toward removing cost as a barrier to treatment of polyps before they become malignant.

It is far easier on the patient to remove a polyp during a colonoscopy than to require a second procedure, Trapp said, and doing so lowers costs and improves health outcomes. If a patient knows that they won’t face additional costs if a polyp is found, it might encourage them to be screened, he said.

“Fewer than 65% of Nebraskans ages 45 to 75 meet the recommendation and receive colorectal cancer screening,” Trapp said. “That is, unfortunately, in spite of the fact that Nebraska has a higher rate of colorectal cancer than the national average.”

Testifying on behalf of AARP Nebraska, June Ryan also spoke in support of LB829. Colorectal cancer is almost entirely preventable with recommended screenings, she said, and yet 1,692 Nebraskans died of colorectal cancer between 2011 and 2015.

“About one-third of adults skip the recommended screenings that could help prevent and help treat this deadly disease,” Ryan said, “and often the reason for skipping these screenings is due to lack of insurance coverage.”

No one testified in opposition to LB829 and the committee took no immediate action on the measure.