SPRING 2012 
  In This Issue:

Medicare and Medicaid Updates

Introducing Care360

EmblemHealth Injectable Drug Utilization Management Program Begins

Claims Corner

Utilization Review Criteria Update

Medical Director Availability After an Adverse Determination

Member Rights and Responsibilities

Provider Advisory Webinars a Success

CAHPS Member Satisfaction Surveys Are in the Field!

Behind the Scenes

Colorectal Cancer Screening

Medication Adherence for Chronic Conditions

Medical Management of COPD

Dental Hygiene Is Important

How to Help Your Patient With ADHD

Your Role in Slowing the Obesity Epidemic

Health and Wellness Programs

What Is a Health Outcome Survey?

Clinical Corner

News&Notes Archive

Colorectal Cancer Screening

Colorectal cancer is the third most common cancer diagnosed in men and women in the United States, excluding skin cancers, and the third leading cause of cancer-related death in New York State. Discussing the importance of colorectal cancer screenings with your patients is critical. Research indicates that willingness to obtain colorectal cancer screening tests depends on multiple factors, including individual disease risk, personal preference and physician recommendation.

Most health plans, including Medicaid and Medicaid managed care, reimburse for age- and risk-appropriate colorectal cancer screening tests. The United States Preventive Services Task Force recommends that men and women at average-risk begin regular colorectal cancer screening at age 50 with any of three tests:

  • A colonoscopy every 10 years
  • A high-sensitivity, multi-slide fecal occult blood test (FOBT) every year
  • A flexible sigmoidoscopy every five years

Patients with a personal or family history of colorectal cancer, history of intestinal polyps or inflammatory bowel disease, and people with a history of certain inherited diseases, such as familial adenomatous polyposis and hereditary nonpolyposis colon cancer, are at increased risk and may need to begin regular screening earlier.

The New York State Department of Health Cancer Services Program (CSP) oversees the delivery of guideline-concordant, comprehensive breast, cervical and colorectal cancer screening services to eligible New Yorkers in every county and borough in the State. Men and women who are uninsured or underinsured for these screening services can contact their local CSP to find out how to get free colorectal, breast and cervical cancer screening. Diagnostic screenings are usually covered by Medicare and most health insurance plans, including EmblemHealth.

The Centers for Disease Control and Prevention has valuable information on colorectal cancer that you may review.


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