Although part of the new health law make many types of preventive healthcare free to patients (and therefore succeed in boosting screening rates for diseases such as breast and colon cancer), physicians and patients are angry over the "loophole" that results in patients getting billed when a screening test becomes diagnostic or procedural.
The most common example of this scenario occurs when a patient undergoes a colonoscopy. If the physician performing the exam finds nothing, the procedure is indeed free to patients. But if the physician removes just one noncancerous polyp during the procedure, the patient wakes up from anesthesia owing hundreds or thousands of dollars.
This circumstance not only harms the patient's wallet but also his or her relationship with the physician. "It erodes a trust relationship the patients may have had with their doctors," said Dr. Joel Brill of the American Gastroenterological Association. "We get blamed. And it's not our fault," he told the Associated Press.
While better patient education over what is and isn't covered can help alleviate the surprise factor, some groups are pushing for the free coverage to be broader. For example, the American Gastroenterological Association and the American Cancer Society are asking Congress to revise the law to waive patient costs, including Medicare copays, for a screening colonoscopy where polyps are removed.
In Oregon, insurance regulators are working with doctors and insurers to ensure patients aren't getting surprise charges for polyp removals, according to the AP, while other states such as Florida and California report they have been inundated with complaints.
To learn more:
- read the AP article from the Seattle Times