Disease prevention advocates are cheering Congress for including preventive-care provisions in the new Medicare law, saying they will help seniors access key screening tests and wellness counseling.
Starting in January, the law extends the time new beneficiaries have to get a Welcome to Medicare physical from six months to
12 months, and the physical is no longer counted against members annual Medicare deductible, typically $135 a year. Today, fewer than 6% of new beneficiaries get this physical. Its going to increase the uptake of people taking advantage of the visit and getting advice on screenings and strategies to stop smoking, said Christy Schmidt, senior policy director for the American Cancer Societys Cancer Action Network.
The law also alters some requirements in the physical exam. Physicians are no longer required to perform an electrocardiogram to receive payment for the visit, for instance. Physicians will now perform a body mass index test, as opposed to just measuring weight, and must provide materials on end-of-life planning such as advance directives. Patients will also get referrals to prevention education programs based on the physical-exam findings.
Another change is that new preventive services dont need congressional approval to be covered by Medicare. Instead, the HHS secretary can use the national coverage determination process to add evidence-based early detection tests such as colorectal screenings to the Medicare program. The secretary will also have some discretion on reimbursement for newly added clinical preventive services.