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Bill advanced to close loophole in insurance coverage for procedures during a colonoscopy

By: - February 6, 2024 11:11 am

The Biden Administration is proposing rules to rein in short-term health insurance plans and also is extending guidance to hospitals to curb surprise medical billing. (Getty Images)

LINCOLN — State Sen. Carol Blood said she got a $900 surprise after undergoing a colonoscopy recently.

The surprise was a $900 bill to remove polyps discovered during the screening procedure, which wasn’t covered by insurance, unlike the colonoscopy itself.

Carol Blood explains a resolution to the Executive Board
State Sen. Carol Blood of Bellevue  (Zach Wendling/Nebraska Examiner)

On Tuesday, state senators voted 36-6 to advance a bill Blood introduced that she said “closed a loophole” in the Affordable Care Act.

The ACA, Blood said, intended to require coverage of the colonoscopy as well as the removal of any polyps found during the procedure.

But a loophole, she said, makes removal of a polyp “diagnostic” and a procedure whose cost is the patient’s responsibility.

Some patients, as they wait to undergo a colonoscopy, refuse to agree to the possible extra payment, Blood said, with life-threatening consequences.

Under Legislative Bill 829, polyp removal, a biopsy and lab tests would be covered by insurance.

Omaha Sen. Kathleen Kauth opposed the bill and questioned whether requiring insurers to cover polyp removals would increase costs for all patients.

But Lincoln Sen. Eliot Bostar said costs would be saved if a patient’s polyps are removed to prevent cancer in the future.

Blood said colon cancer kills 53,000 Americans a year and is the second-leading cause of cancer deaths.

The bill, she said, was important for Nebraska because it has a higher rate of colon cancer than nationally — 40.5 per 100,000 state residents versus 36.5 per 100,000 nationally.

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Paul Hammel
Paul Hammel

Senior Reporter Paul Hammel has covered the Nebraska state government and the state for decades. Previously with the Omaha World-Herald, Lincoln Journal Star and Omaha Sun, he is a member of the Omaha Press Club's Hall of Fame. He grows hops, brews homemade beer, plays bass guitar and basically loves traveling and writing about the state. A native of Ralston, Nebraska, he is vice president of the John G. Neihardt Foundation.

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