BCBS IL Updating Colorectal Screening Guidelines
Blue Cross and Blue Shield of Illinois (BCBS IL) announced they are updating their claims processing guidelines to align with new government recommendations on colorectal screenings. Under the new rules, BCBS IL will cover routine screenings starting at age 45 instead of 50. The change stems from an increase in colorectal disease, specifically cancer, among younger people. Screening should continue until age 75 per government recommendation and BCBS IL policy. Their preventive care guidelines allow coverage for the following:
Annual guaiac fecal occult blood test (gFOBT)
Annual fecal immunochemical testing (FIT)
DNA-FIT (stool DNA test) every 1 to 3 years
Flexible sigmoidoscopy every 5 years
Flexible sigmoidoscopy every 10 years with annual FIT
CT colonography every 5 years
Colonoscopy every 10 years
BCBS still recommends and covers screenings prior to age 45 for patients with certain risk factors including a family history of colorectal disease. Visit the below link for further details:
https://www.bcbsil.com/pdf/education/bluereview/aug_21.pdf
Covid Pandemic Pushes More People into ACA Exchange Plans and Medicaid
The Centers for Medicare & Medicaid Services (CMS) released data for the 2021 special enrollment period the Biden administration initiated in response to the Covid pandemic. The data shows that over 2.5 million people enrolled on HealthCare.gov and state marketplaces during the period, which ended on August 15th. The American Rescue Plan, passed by Congress and signed by President Biden in March of 2021, added significant funds to the exchanges to lower premiums and out-of-pockets costs for enrollees, making them more affordable and attractive to a broader segment of the uninsured population.
CMS also announced that enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) reached a record high of 81.7 million. Since the beginning of the pandemic in early 2020, enrollment in these two programs has increased by a staggering 11 million people, and now represents nearly 25% of the national population. The increased enrollment in these various programs illustrates the continued effects of the Covid pandemic on the healthcare industry. The large swings in the employment rates have forced many people to find new insurance coverage as their employment status changed over the past year. Visit the below link for further details: