WASHINGTON – On Thursday, Reps. Mike Thompson (D-CA) and Jim Ramstad (R-MN) introduced legislation to improve beneficiary access to Medicare's cancer screening services.
The Medicare Early Detection of Cancer Promotion Act will waive co-pays for colonoscopy and mammography services and extend the eligibility period for the "Welcome to Medicare" visit from the current time frame of six months to one year.
"The vast majority of cancer diagnoses and deaths happen to older Americans, so we should be making it as easy as possible for seniors to get regular cancer screenings," said Thompson.
Sixty percent of new cancer diagnoses and 70 percent of cancer deaths occur in people over 65. "Co-pays for these services create a barrier to care," added Thompson. "If we eliminate the co-pays, more seniors will get screened, saving lives and money."
"Nearly 100,000 Americans will die this year from colorectal and breast cancer, yet many of these deaths could have been prevented" said Ramstad. "By passing the Medicare Early Detection of Cancer Promotion Act, we can expand access to life-saving colonoscopy and mammography services, services that are truly the first line of defense in preventing cancer deaths."
Currently, beneficiaries pay no coinsurance for most cancer screening services covered by Medicare, but they must pay a 20 percent co-pay for colonoscopy and mammography services.
This legislation will eliminate co-pays for mammograms and colonoscopies, prompting more seniors to utilize these live-saving services.
In addition to saving lives, promoting cancer prevention also saves Medicare – and the American taxpayer – money.
Preventive services cost considerably less than caring for people with cancer. For example, Medicare pays between $200 and $400 for a colonoscopy – but if colon cancer metastasizes, total costs of care can exceed $58,000 per patient.
The efficacy of cancer prevention screening is clear. When caught in the first stages, the five-year survival rate for breast cancer is 98 percent and the five year survival rate for colorectal cancer is 90 percent.
However, if these cancers move into more advanced stages, the survival rates are only 26 percent for breast cancer and 10 percent for colorectal cancer.
This legislation will also increase the number of seniors who seek cancer prevention services by extending the "Welcome to Medicare" period. During these physicals, Medicare beneficiaries can take advantage of certain screening and preventive health services and learn about others.
Currently, fewer than 5 percent of new beneficiaries are seeking appointments for the "Welcome to Medicare" visit, and extending the eligibility period means that more people will be able to benefit from it.
Thompson and Ramstad are both members of the Ways & Means Health Subcommittee.
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SACRAMENTO – The Assembly Committee on Public Safety voted 4-0 July 2 to approve SB 568, a bill by Senator Patricia Wiggins (D-Santa Rosa) to allow county jail facilities to provide medications to defendants with mental illnesses so the defendants can stand trial.
Existing law provides that if a defendant is found to be mentally incompetent to stand trial or “IST,” the trial or judgment is suspended until the IST defendant is restored to mental competency. Existing law also requires the county sheriff to take the IST defendant to a state hospital or treatment facility in order to restore the defendant to competency.
If an IST defendant has been accused of committing a felony offense, involving great bodily harm or another serious crime, the law allows the defendant to be involuntarily medicated in a mental hospital or facility. Unfortunately, it can take up to six months from the date a defendant is determined to be incompetent until the time they are moved to a treatment facility due to a shortage of suitable beds.
“This is an unfortunate situation for all parties – the defendant with a mental condition, the sheriff subjected to a defendant who can refuse medications or treatment in a jail facility, and other individuals who are incarcerated along with the mentally ill defendant,” Wiggins said.
If SB 568 becomes law, counties would be allowed (following a required court hearing) to medicate defendants diagnosed as mentally ill and found by a judge or jury, in concurrence with the county board of supervisors, the county mental health director, sheriff and chief of corrections, to be incompetent to stand trial.
The bill also requires the evaluating psychiatrist to determine whether a defendant could be effectively medicated and restored to competency in a jail or, if not, what level of hospitalization would be needed to restore the defendant to competency. In addition, SB 568 requires the Department of Mental Health to report to the Legislature on such items as the number of IST defendants currently in the system and the resources available for treatment.
During the past year, 28 mentally ill defendants spent 1,578 days (an average of 56 days) incarcerated in the Sonoma County jail while awaiting transfer to an inpatient unit or state hospital – at a cost to the county of $246,000.
"The reality is, more and more mentally ill are being housed in jails, which by definition are not treatment facilities,” Wiggins said. “This bill serves as an interim measure and the county jails have assured me they have no intention of becoming permanent mental hospitals.”
SB 568 is supported by the California Psychiatric Association, the California Mental Health Directors Association, the Sonoma County Board of Supervisors, California State Association of Counties, the California Sheriff’s association, and many other county sheriffs’ offices throughout the state. The bill will be heard in the Assembly Appropriations Committee in the next few weeks.
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