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S 2949119th CongressIn Committee
Colorectal Cancer Payment Fairness Act
Introduced: Sep 30, 2025
Sponsor: Sen. Booker, Cory A. [D-NJ] (D-New Jersey)
HealthcareSocial Services
Standard Summary
Comprehensive overview in 1-2 paragraphs
The Colorectal Cancer Payment Fairness Act would change how Medicare covers certain colorectal cancer (CRC) screening tests by removing patient coinsurance for those tests. Specifically, it amends the Medicare statute to eliminate the coinsurance requirement for these CRC screening tests, and it sets a timeline in which Medicare would pay 100 percent of the cost starting in 2026 and continue thereafter. The bill also removes a sunset provision that previously limited this arrangement through a specific date (January 1, 2030), making the change effectively permanent. The intended effect is to reduce out-of-pocket costs for beneficiaries undergoing CRC screening, potentially increasing screening rates and early detection.
Key Points
- 1Eliminates coinsurance for certain Medicare Part B colorectal cancer screening tests.
- 2Commits Medicare to 100 percent payment for these tests beginning in 2026 and continuing in all future years.
- 3Removes the sunset date (January 1, 2030) that would have limited the policy, creating a permanent change.
- 4Applies to “certain colorectal cancer screening tests” as defined in Section 1833(dd) of the Social Security Act; does not address all Part B services or non-screening tests.
- 5Implemented by amending 42 U.S.C. 1395l(dd) to reflect these changes.
Impact Areas
Primary group/area affected: Medicare beneficiaries enrolled in Part B who undergo CRC screening tests (e.g., screening colonoscopy, stool-based CRC tests, and other qualifying screening procedures).Secondary group/area affected: Medicare program costs and budgeting (higher upfront federal outlays for 2026 onward due to 100 percent coverage), and healthcare providers who perform CRC screening tests (simplified billing with no patient coinsurance).Additional impacts: Potential influence on screening uptake and early detection rates, possible downstream effects on CRC treatment costs and overall healthcare utilization; potential changes in private insurance coverage or cost-sharing dynamics as payers respond to Medicare’s expanded coverage.
Generated by gpt-5-nano on Oct 16, 2025