HR 5671119th CongressIn Committee

Colorectal Cancer Payment Fairness Act

Introduced: Sep 30, 2025

Sponsor: Rep. Watson Coleman, Bonnie [D-NJ-12] (D-New Jersey)

Healthcare

Standard Summary

Comprehensive overview in 1-2 paragraphs

This bill would amend title XVIII of the Social Security Act to remove the coinsurance requirement for certain colorectal cancer screening tests provided under the Medicare program. In practical terms, it would reduce or eliminate the out-of-pocket costs that Medicare beneficiaries pay when they undergo defined colorectal cancer screening tests. The exact tests and the precise definitions would be set forth in the statute, but the aim is to increase access to screening by removing cost barriers for beneficiaries.

Key Points

1Elimination of coinsurance: The bill would remove the 20% coinsurance that Part B beneficiaries typically pay for the specified colorectal cancer screening tests, aligning these tests with preventive services that have minimal or no cost-sharing.
2Scope of tests: The bill covers “certain colorectal cancer screening tests,” with the specific tests and eligibility defined in the statute. The intent is to cover screening tools such as those commonly used for colorectal cancer screening, though the exact list would be in the bill’s text.
3Coverage under Medicare: The change would be implemented as an amendment to Title XVIII of the Social Security Act, affecting how these screening tests are paid for under Medicare.
4Prevention focus: By reducing cost-sharing, the bill seeks to encourage more people to participate in routine colorectal cancer screening, potentially leading to earlier detection and improved health outcomes.
5Interaction with other costs: The bill’s impact would primarily affect beneficiary coinsurance for the covered screening tests; it may not alter cost-sharing for non-covered services, diagnostic follow-ups, or treatments arising from findings that fall outside the defined screening scope.

Impact Areas

Primary group/area affected:- Medicare Part B enrollees, particularly adults eligible for colorectal cancer screening (e.g., older adults and others covered by Medicare).Secondary group/area affected:- Healthcare providers and facilities that perform colorectal cancer screening tests, who may see changes in utilization patterns and billing practices.Additional impacts:- Federal budgetary impact on Medicare due to reduced patient cost-sharing; potential long-term effects on screening rates, early detection, and downstream medical costs.Sponsor and full text are not provided; details such as the exact list of covered tests, frequency intervals, and any exceptions would be defined in the enacted language.The bill’s effect on diagnostic procedures or treatments that may occur after an initial screening would depend on how those services are classified under the statute.

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