December 29, 2011
By: Bruce Berry
Last year's healthcare reform law included language that requires health insurance companies to pay for preventive care in the hopes of preventing more expensive issues later. However, The Associated Press reports there is significant confusion about some aspects of the rule.
In one case chronicled in the report, an Arizona man went to the hospital for a recommended colonoscopy, which would have fallen under a preventive treatment. However, when doctors performed the procedure, they removed two polyps they found during the process.
That changed the preventive screening into a diagnostic test, meaning it was no longer covered under that provision and the consumer received a bill. While some consumers felt the issue resembled fraud, doctors say it's an issue on both sides. One consultant told the AP that doctors across the country are "extremely" confused.
"It erodes a trust relationship the patients may have had with their doctors," Dr. Joel Brill of the American Gastroenterological Association told the AP. "We get blamed. And it's not our fault."
The news source reports that the AGA and American Cancer Society are working with lawmakers to address this issue and support the use of preventive screenings.
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