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Wed Feb 20, 2013, 05:20 PM

Here’s one way Obamacare changed today

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/02/20/heres-one-way-obamacare-changed-today/

Here’s one way Obamacare changed today

Posted by Sarah Kliff on February 20, 2013 at 2:58 pm


The department of Health and Human Services is out with another regulation for the Affordable Care Act, this one detailing the package of benefits that each insurance company must cover.

snip//

We’ve known all along that colonoscopies count as one of the preventive services that insurers must cover without copayment, as they are a screening recommended by the United States Preventive Services Task Force.

What we haven’t known though, was what would happen if, during a colonoscopy, a doctor discovered a polyp and removed it. Would that still count as a screening—or would it cross the line into a treatment that the patient would need to pay for. Harris Meyer raised the issue back in April, writing for the Los Angeles Times:

snip//

Today, the administration resolved this issue: It decided that insurance companies cannot charge patients for the removal of a polyp during a recommended colonoscopy. From an FAQ issued by the Department of Labor:

Q5: If a colonoscopy is scheduled and performed as a screening procedure pursuant to the USPSTF recommendation, is it permissible for a plan or issuer to impose cost-sharing for the cost of a polyp removal during the colonoscopy?
No. Based on clinical practice and comments received from the American College of Gastroenterology, American Gastroenterological Association, American Society of Gastrointestinal Endoscopy, and the Society for Gastroenterology Nurses and Associates, polyp removal is an integral part of a colonoscopy. Accordingly, the plan or issuer may not impose cost-sharing with respect to a polyp removal during a colonoscopy performed as a screening procedure. On the other hand, a plan or issuer may impose cost-sharing for a treatment that is not a recommended preventive service, even if the treatment results from a recommended preventive service.


There it is: Colonoscopy patients will not wake up to a surprise, post-operative bill.

9 replies, 1857 views

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Arrow 9 replies Author Time Post
Reply Here’s one way Obamacare changed today (Original post)
babylonsister Feb 2013 OP
zappaman Feb 2013 #1
LeftInTX Feb 2013 #7
Cronus Protagonist Feb 2013 #2
Whisp Feb 2013 #3
Cronus Protagonist Mar 2013 #8
babylonsister Feb 2013 #4
great white snark Feb 2013 #5
BlueStreak Feb 2013 #6
Rosa Luxemburg Mar 2013 #9

Response to babylonsister (Original post)

Wed Feb 20, 2013, 05:51 PM

1. Gonna be getting my first one this year!

Can't wait!


But this is good to know!
Still don't understand how so many people have been brainwashed about how awful Obamacare is...

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Response to zappaman (Reply #1)

Thu Feb 21, 2013, 12:55 AM

7. The prep is the worst part

Starving without food combined with laxatives.

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Response to babylonsister (Original post)

Wed Feb 20, 2013, 06:08 PM

2. I've had four of these in January this year.

All on Obamacare. All free. A big THANK YOU to him for pushing through Obamacare. At the time, I was against OBamacare as it seemed to me to just be a big giveaway to the insurance companies, but I had not foreseen local counties making their own insurance companies and competing in the marketplace with the usual for-profit culprits. They win every time - you can't beat free, and you can't pay for limos and glass buildings off the profits from free either.

So, instead of being an indigent bad-debtor patient struggling to live I'm a proud holder of an insurance card that covers everything. Prescriptions to colonoscopies. And I've had one polyp removed, two more to come in my next couple of free operations.

I'm not exactly dancing on tables because this is serious stuff, but I can say it is a relief to be able to go to the hospital for treatment and not be hassled by money-grubbing financial "experts" who are convinced you're lying to try to get out of paying. What a relief.

Obama, I don't have any money, but if you ever feel the need for a back rub, I'm your man.

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Response to Cronus Protagonist (Reply #2)

Wed Feb 20, 2013, 06:11 PM

3. :)

I am very happy that you have been helped.

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Response to Whisp (Reply #3)


Response to Cronus Protagonist (Reply #2)

Wed Feb 20, 2013, 06:59 PM

4. Great post; thanks for sharing!! nt

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Response to babylonsister (Original post)

Wed Feb 20, 2013, 07:29 PM

5. But Obamacare was a Republican idea!

To that I say...does it fucking matter where it came from if it's helping people and getting us closer to single pay?

I wish more people would get colonoscopies so they can find where their heads have been.

Now regarding the OP, this is good news and thanks for posting babylonsister.

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Response to babylonsister (Original post)

Wed Feb 20, 2013, 11:32 PM

6. Two months too late for me, I'm afraid

I haven't added up all the bills, but the total cost to me was well over $1000. To me, the most astounding of all the charges was the post-operative recovery. There wasn't much to the recovery. I just had to prove I could pee and then they remove the IV and gave me a muffin. Total charge: about $2000. That was face value. The insurance company knocked that down by 80% I bet.

It is all just a game.

But I am just happy there weren't problems much worse than polyps. And it is nice to know that when I go back for a re-test in 3 years, while Obama is still president, there will be no price gouging. I already spend something like $700 a month for my coverage.

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Response to babylonsister (Original post)

Tue Mar 19, 2013, 11:29 PM

9. Good post!

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