Health Plans Can No Longer Impose Cost Sharing for Follow-up Colonoscopy

The policy loophole that allowed patients to be charged for colonoscopy following a positive non-colonoscopy screening text has been plugged. On January 10, the U.S. Departments of Labor, Health and Human Services, and the U.S. Treasury issued FAQs regarding coverage of colonoscopies pursuant to USPSTF recommendations. The FAQ specifies that plans are required to cover without cost-sharing, a follow-up colonoscopy performed to evaluate a positive non-invasive stool-based screening test or direct visualization test. Plans and issuers must provide coverage without cost sharing for plan or policy years beginning on or after May 31, 2022.

There are some limitations, to find out more visit View the FAQs (see questions seven and eight on pages 11-12). You can also visit the American Cancer Society’s CAN press release to learn more at: New Guidance from Administration Helps Ensure Coverage for Follow-up Colonoscopies, Will Save Lives from Colon Cancer.