Colorectal Cancer Payment Fairness Act
Summary
What This Bill Does
The Colorectal Cancer Payment Fairness Act changes Medicare payment for certain colorectal cancer screening tests. Section 1833(dd) of the Social Security Act currently includes a phase-in schedule for Medicare payment when a colorectal cancer screening test is affected by coinsurance rules. This bill removes the date-limited language before January 1, 2030, strikes the 85 percent payment language through 2026, removes the later phase-down subparagraph, and makes the payment percentage 100 percent for each subsequent year. The practical effect is to eliminate remaining beneficiary coinsurance for the covered colorectal screening tests instead of letting partial cost-sharing continue during the phase-in.
Who Benefits and How
Medicare beneficiaries needing colorectal cancer screening benefit because covered tests can be paid at 100 percent without remaining coinsurance. Older adults at elevated colorectal cancer risk benefit if lower out-of-pocket costs make screening easier to complete. Gastroenterology practices benefit when patients face fewer cost-sharing barriers for covered screening services. Cancer prevention advocates benefit from a cleaner Medicare payment rule supporting screening uptake.
Who Bears the Burden and How
CMS Medicare payment staff must update payment rules, claims systems, and provider guidance for section 1833(dd). Medicare Administrative Contractors must process claims using the revised 100 percent payment rule. Federal Medicare financing bears the cost of shifting remaining coinsurance away from beneficiaries. Federal taxpayers help fund higher Medicare payments for the covered screening tests.
Key Provisions
- Amends Social Security Act section 1833(dd) for certain colorectal cancer screening tests.
- Provides 100 percent Medicare payment for each subsequent year instead of the prior phase-down schedule.
- Removes remaining beneficiary coinsurance for covered screening tests.
- Requires CMS and Medicare contractors to update payment and claims processing rules.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Eliminates remaining Medicare beneficiary coinsurance for certain colorectal cancer screening tests by making the Social Security Act section 1833(dd) payment percentage 100 percent for each subsequent year rather than phasing down through 2030.
Key Policy Areas
Medicare, Cancer Screening, Health Care
Primary Purpose
Eliminates remaining Medicare beneficiary coinsurance for certain colorectal cancer screening tests by making the Social Security Act section 1833(dd) payment percentage 100 percent for each subsequent year rather than phasing down through 2030.
Policy Domains
Resolution provisions
Identified Gains
- Medicare beneficiaries needing colorectal cancer screening
- Older adults at elevated colorectal cancer risk
- Gastroenterology practices
- Cancer prevention advocates
Identified Costs
- CMS Medicare payment staff
- Medicare Administrative Contractors
- Federal Medicare financing
- Federal taxpayers
Sponsors
Legislative Progress
In CommitteeMrs. Watson Coleman (for herself, Mr. Fitzpatrick, and Mr. Carter …
Referred to the Committee on Energy and Commerce, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Federal Medicare financing, Medicare beneficiaries needing colorectal cancer screening, Older adults at elevated colorectal cancer risk
Positive-direction: Medicare beneficiaries needing colorectal cancer screening, Older adults at elevated colorectal cancer risk
Negative-direction: Federal Medicare financing
Medicare Administrative Contractors
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology