May 12, 2009

Medicare Nixes "Virtual Colonoscopies"

CBS Evening News: Government Won't Pay For Non-Invasive Screening Despite High Detection Rate

  • Play CBS Video Video Virtual Colonoscopy Conundrum

    Medicare has announced that it will not pay for virtual colonoscopies, although the American Cancer Society says that this screening should be available. Medical correspondent Dr. Jon LaPook reports.

  • CT colonography images

    CT colonography images  (CBS)

  • Interactive Conquering Colon Cancer

    Check out facts & figures, test your colorectal cancer IQ with our quiz and much more.

  • Only On The Web Your Health In Focus

    CBS News Medical Correspondent Dr. Jon LaPook hosts a weekly show, CBS Doc Dot Com, all about health issues.

(CBS)  Medicare announced Tuesday it will not pay for so-called "virtual colonoscopies."

In 2006, 200,000 of them were performed in the United States. Overall, Americans have more than 14 million colonoscopies every year, and doctors agree doing more would save thousands of lives.

CBS News medical correspondent Dr. Jon LaPook reports the government's rejection of the latest high-tech approach was a big disappointment to many advocates of colon cancer prevention.

Dr. Otis W. Brawley, chief medical officer of the American Cancer Society says, "The American Cancer Society believes that virtual colonoscopy, or CT colonography, ought to be available as one of several options for colon cancer screening."

In a traditional colonoscopy, a fiberoptic instrument is used to examine the lining of the colon and remove polyps. In virtual colonoscopy, images of the colon are generated by a noninvasive body scan. Both have a similar detection rate for significant polyps; traditional colonoscopy usually costs at least twice as much.

The government maintains that, "The evidence is inadequate to conclude that CT colonography is an appropriate colorectal cancer screening test."

One concern is that costs would increase because polyps found by virtual colonoscopy require traditional colonoscopy to remove them. Advocates say reaching more people is worth the added expense.

"Right now about 40 percent of people over the age of 50 are getting any kind of screening for colon cancer," Brawley says. "We believe if virtual colonoscopy were more available, more people would be screened and more lives would be saved."





©2009 CBS Interactive Inc. All rights reserved.
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by sjc_1 May 18, 2009 12:46 PM EDT
ALL of health care costs WAY too much. We know this. We have THE most expensive but not the best health care in the world. It is time ALL the health care providers take a pay cut and it is way past the time that we have National Health Insurance.
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by mutnauq4842 May 14, 2009 10:01 PM EDT
What, as compared to cardiologists, radiologists, and orthopedic surgeons? Nurses make too much? Now THAT opinion is out of whack!
Posted by tmn at 6:11 PM : May 12, 2009

RNs need a minimum of a 2 yr associate degree.
Reply to this comment
by mutnauq4842 May 14, 2009 9:57 PM EDT
A Future of the Brave
Posted by searingtruth at 10:48 PM : May 12, 2009

You are so bogus and full of it.
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by mutnauq4842 May 14, 2009 9:55 PM EDT
CMS feels there is no need for virtual colonoscopies because they have an advantage the common senior citizen does not-CMS has their head up their azz.
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by ColonCancerAlliance May 14, 2009 8:17 PM EDT
The Colon Cancer Alliance is extremely disappointed that the Center for Medicaid Services (CMS) opted to deny coverage for CT Colonography (CTC), commonly known as virtual colonoscopy. CTC has proven to be a very effective method of early detection and prevention of colon cancer. This decision now leaves millions of older Americans exposed to a higher risk of colon cancer. It also exacerbates an unequal standard of care between Medicare beneficiaries, who do not have the choice to undergo a virtual colonoscopy, and those with private insurance who do. America?s seniors deserve better. They deserve the same access to colorectal screening tools as Americans fortunate enough to have private health insurance.

?About 150,000 Americans are diagnosed with colorectal cancer every year, the majority of them Medicare aged. It?s the third highest cause of cancer in the country and the second leading cause of cancer deaths. Caught early, it has cure rates of more than 90 percent and through proper screening can be avoided entirely.

Making virtual colonoscopy more easily available as an alternative to standard colonoscopy would be an important tool that ultimately motivates more Americans 50-plus (45 in certain minorities) to undergo a screening they might otherwise skip. Improved access to virtual colonoscopy has the potential to increase screening rates enough to save both lives and money.

It?s the right of an American senior to screen for colon cancer using any form of medically accepted, effective procedure they and their doctor choose. This is especially true in the case of virtual colonoscopy, where it?s cheaper, less invasive and equally medically effective as standard colonoscopy. By denying coverage for virtual colonoscopy, CMS is sending the signal that increased screening amongst the Medicare beneficiary population is unimportant. The Colon Cancer Alliance and its members strongly disagree with this sentiment. Medicare beneficiaries deserve access to virtual colonoscopies. We urge CMS to immediately re-open a coverage decision so it can consider additional data pertaining to the age 65 and above population.

Andrew Spiegel
Chief Executive Officer
Colon Cancer Alliance
(202) 434-8996 office
www.ccalliance.org
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by whitemale08 May 13, 2009 8:23 PM EDT
WELCOME TO THE OBAMA AUSTERITY HEALTH PLAN TO PAY FOR BAIL OUTS TO GOLDMAN SUCKS AND WARREN BUFFET WHO PRACTICLY OWNS ALL INSURANCE CO.

Folks, I tried to WARN you that all of us will pay for these stupid bank bail outs with forced austerity.

There is more austerity to come folks because the stress-tests was the green light to continue all bailouts.
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by veils-2009 May 13, 2009 4:30 PM EDT
Health Industry lobbyists have infected this non-invasive practice with the guise of practicality, cloaking profitability.

The big scare here is:
Once this technology get rooted into normal procedure for colonoscopy, it will quickly migrate into other medical practices; from bones to breasts. This procedure is carried out by technicians instead of doctors reducing the overall costs of a diagnosis and gaining almost 100X improvement in tissue image resolution compared to current "an al-log" methods.
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by I_am_me1953 May 13, 2009 3:54 PM EDT
Ummm, last time I heard, Medicare and Medicaid are GOVERNMENT run health care programs....what does an insurance company have to do with the GOVERNMENT telling you
Posted by AmericaGetsChumpChange at 7:20 AM : May 13, 2009
____________________________

Because what the govt allows will soon be standard for BCBS.
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by kozynferg May 13, 2009 12:08 PM EDT
For those screaming that this is what will happen with "socialized Medicine", most private insurance companies, Blue Cross/Blue Shield for instance, refuse to pay for virtual colonoscopies. This even when complications mean the patient can not have a regular colonoscapy.
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by platteman May 13, 2009 10:32 AM EDT
Welcome to Obambi care.!!!!! We are now on the road to socialized medicine. Glad all you left wing nut jobs love the chosen one who is now telling banks how to pay people, letting the unions own the car companies, and soon will tell you how much you can drive, what medicines to take and the rest.
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by creeper00 May 13, 2009 10:05 AM EDT
And there you have it...the commies are already starting to limit your medical options....

You're just going to love your new government health care plans when they tell you SORRY, we can't afford it.....we needed your health care dollars to buy our commie civil militia that will support our communist regiime and keep the dissidents in line.
Posted by AmericaGetsChumpChange at 6:50 AM : May 13, 2009

I share your scorn, AGCC, but would like to point out that they will STILL pay for the more expensive procedure. Can anyone make sense out of that?

On a personal note, I have had the procedure in question. It's amazing. I have diverticulitis and it picked up every little pocket.

Is this what we get when we allow insurance companies to dictate medical practice?
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by babooph May 13, 2009 9:37 AM EDT
"Virtual colonoscopies"-? is that what we call the propaganda systems version of the "NEWS"?
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by andie52 May 13, 2009 9:13 AM EDT
Both procedures involve the same patient bowel preparations. However, no sedative is administered for CT colonography. CT colonography involves taking a series of scans in a 15-20 minute procedure.

Computer software translates the scans into a readable format. Because CT can only take pictures, suspicious polyps cannot be removed during this procedure. If suspicious polyps are identified, a subsequent colonoscopy should be scheduled, and if a facility cannot do it the same day as the colonography was performed, the patient must repeat the bowel preparation procedure for the follow-up colonoscopy.

http://www.medicalnewstoday.com/articles/142083.php
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by clancy49 May 13, 2009 8:50 AM EDT
mjvwsr==The virtual test costs less than traditional. The real reason to keep traditional is that it is more expensive and far more dangerous than the virtual. We can kill the old people off faster and that way the lobbyists get more money and can whine more about costs. The patient will have to pay not just for the scan, but the Anaesthist, the radiologist, the procedure, and the out patient hospital fee. The virtual test requires only a location and a technician. The radiologist would read the scans later. It is to keep us broke and dependent. Why not just let old age, cancer, diabetes, get us? None of us will get out of it alive anyway, even the super wealthy elitist. None of us are that important, even the taxing President doesn't matter all that much in the big scheme of things. We can fight back in our own way, accept death as inevitable and don't go to any doctor or have any tests. If you can't fix it yourself, well then it is time to go.
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by antoniof123 May 13, 2009 8:49 AM EDT
I think its wonderful that the government is taking over our health care decisions. They are so much smarter about things than we are. Someday we wont have to worry our little minds about this stuff at all. Our government will have rules that guide us all the way.
Posted by McHineguy at 10:19 PM : May 12, 2009

Hey wing nut this is because the GOP stoped taking care of its people and deregulated everything and then borrowed and spent like drunken saliors on shore leave.

Now they find their fiscal breath. No thank you this swing voter has had enough like so many others. Good luck in the future purifying your party that should leave you with about 15 million voters the ones who listen to Rush, Bill, Sean, Ann, Glen and the rest of the wing nuts.
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by mjvwsr May 13, 2009 7:52 AM EDT
the future of our government health care system. let's not use progressive techniques because it's too expensive.
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by skeezix06 May 13, 2009 7:19 AM EDT
Doing things the hard and painful way is a throwback to our religious/puritan base.
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by longtree-2009 May 13, 2009 7:12 AM EDT
Medicare is proactively making sure seniors die early. from what seniors tell me, who are on medicare, the premimums they pay are high, and they also have additional costs for senior hmo insurance all out of limited income, retired. in this economy, they are trying to find a job which is difficult for them due to their age. medicare has found a way to eradicate seniors.
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by pepperwood2 May 13, 2009 2:24 AM EDT
Health Industry Promises Obama $2T In Cuts - Obama Says Proposal To Slow Rate Of Cost Increases Is "Historic"

Yes I expect that everybody including us seniors will be getting cuts in treatment, reduced, limited or NO CARE for preventative medicine. Thanks to the increased contributions & donations by healthcare lobbyists. That slow rate of costs increases will only apply to what your HEALTHCARE or MEDICARE will have to pay. You have to make up the rest. While the billions in fraud within the system runs rampant. Thats a large part of the high costs that you hear not about nor Congress wants to address. BO is not being very transparent about it. All this BOBS Rhetoric is suppose to be enough to make you feel better, if not, we'll get another dose in a couple of months of how miraculous this Plan is working.

SAVING Health & Medicare BILLIONS in payouts, WHILE providing RECORD profits for your HMO or Insurance Provider. Rest assured that these CUTS will not happen to President BOBS or Congressional Healthcare Coverage. Just guess who will be paying for this exclusive HEALTH PLAN while BOBS Boys find other ways for us to Pay Off The Record National Deficit they Created.

How about a tax on soda, and other drinks that contain CO2 that will make his GW & Green Friends $$$$$$. Just for starters. Don't expect anything to get any better for us. We are the Source of Their Food in BOBS Boys Food Chain. Pretty Slick Trick.
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by mcapek May 13, 2009 1:27 AM EDT
Stool testing is UNRELIABLE for detection of polyps and cancers; negative blood stool sample is meaningless. And most positive stool samples are due to hemorrhoids, also very misleading. Show me which medical society recommends stool testing as the sole method of preventing colon cancer; the answer is NONE.

I agree that virtual colonoscopy involves radiation, and thus carries a slight, but unproven risk, of long term radiation damage, and tiny increased risk of radiation
induced cancers. Screening colonoscopies in general population are recommended once every 10 years. That is insignificant. And only a fool suggests that radiologist recommend tests to line their pocket. Most radiologists are already overwhelmed by the demand for their service. People are beating down on their door, demanding service. The high tech technology has eliminated what used to be routine exploratory laparatomies (surgeon opening up the belly), and brought huge advances in detection and characterization of diseases, saving money by shortening hospital stays, preventing advanced diseases, monitoring treatment effectiveness, and eliminating lot of uncertainty in medicine. It used to be said that clinician came up with 90% of the diagnosis, and in 10% used radiology as a confirmatory test. Just the opposite is true today. Your orthopaedist uses MRI to figure out what is wrong with your knee, so he can plan your treatment accordingly, instead of scoping everyone, looking for the source of pain. The end result is that you SAVE money by doing imaging, instead of surgical procedures. Now if you want to discuss those people who see money by putting a scanner, lab, or other technical gismo in their private clinic and their running all of their patients through the machine, that is another story. It has been shown that when a nonradiologist buys imaging equipment and puts it in their office, the utilization goes up ten fold.
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