Center for Health Policy

CMS Will Cover New Colorectal Cancer Screening Tool

The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover Cologuard – a multitarget stool DNA test – as a colorectal cancer screening test for asymptomatic, average risk beneficiaries, aged 50 to 85 years.
Therefore, Medicare Part B will cover the Cologuard test once every three years for beneficiaries who meet certain criteria.

Read the full decision memo here.

State Innovation Waivers

Many conservative states have been rankled by the health reform law. However, some state lawmakers are looking forward to an ACA waiver, known as the section 1332 or state innovation waiver, that could allow states to drop major portions of the ACA such as the individual mandate and the insurance exchanges and instead design an alternative health system for the state. This waiver will be available starting in 2017 and it is different than the waiver some states have used for Medicaid expansion (e.g. privatize Medicaid). The only stipulation is that the state will need to demonstrate that their plan will maintain the same coverage levels and do so at the same cost to the federal government. Read more about the waiver here.