Two U.S. senators have introduced legislation to raise the reimbursement rate that Medicare pays for screening mammography. The bill would boost payments from $69 to $90, an increase of 30%, and would also allocate funding to train additional mammographers and radiologic technologists.
Sen. Tom Harkin (D-IA) and Sen. Olympia Snowe (R-ME) on March 15 introduced the legislation, called the Assure Access to Mammography Act of 2001. Harkin's office said the bill was designed to head off a looming crisis in which many imaging facilities can no longer afford to offer breast screening services due to low Medicare reimbursement and a shortage of trained staff.
Medicare payments have not kept pace with rising healthcare costs, Harkin said. As a result, some 250 mammography facilities have closed their doors in the past 18 months, according to the senator.
At the same time, screening rates are rising as more women recognize the value of regular checkups. In 1998, nearly 67% of women over 40 in the U.S. were screened for breast cancer, a significant increase from the 28.7% who underwent screening mammography in 1987, according to figures provided by Harkin's office.
In addition to the payment increase, the bill will address the mammography personnel shortage in two ways. It will:
- Increase Medicare funding for graduate medical education to support additional radiology residency slots.
- Increase the number of technologists available to conduct mammograms by increasing funding of the Allied Health Projects loan program. The program supports continuing education for technologists through the Health Resources and Services Administration, a branch of the U.S. Department of Health and Human Services.
Radiology advocates were quick to praise the legislation. The American College of Radiology in Reston, VA, plans to fully support the bill, according to Dr. Harvey Nieman, chairman of the ACR’s board of chancellors.
"We think this brings to the center an important issue -- that there is a significant and impending crisis in access for women," Nieman said. "Screening mammography is undercompensated, and we believe that if [the bill] goes forward, this will be redressed and women will continue to have outstanding quality care with full access."
The $90 reimbursement rate is "a reasonable start," Nieman said. However, it’s possible the ACR could advocate increasing that rate as the bill moves through Congress. The number was based on statistics provided by the Health Care Financing Administration regarding the cost of providing screening mammography, according to a spokesperson for Sen. Harkin.
In another important point, the bill would also delay transfer of the power to set screening reimbursement rates from Congress to a special commission known as the Relative Value Update Committee (RVUC). A bill passed last year mandated that the committee begin setting screening rates on January 2, 2002; Harkin's bill would postpone that mandate by one year.
The delay would be a victory for mammography advocates, who believe the RVUC process could set rates too low by not accounting for the costs centers incur in complying with the Mammography Quality Standards Act, Nieman said. The ACR would like to see control over screening reimbursement levels remain permanently in Congress.
Both Nieman and representatives in Harkin’s office are optimistic that the legislation will be passed. Harkin’s office is busy signing on co-sponsors, and a similar bill is also being introduced in the House of Representatives.
Nieman said the ACR is drumming up support for the legislation by urging members of the radiology community to write their representatives regarding the bill, especially if they know of situations in which women's access to screening mammography was delayed.
"We need to address this before it truly does become a crisis," Nieman said.
By Brian Casey
AuntMinnie.com staff writer
March 19, 2001
Related Reading
Changes in Medicare reimbursement for screening mammograms, February 23, 2001
Harkin will introduce bill to raise screening mammography payments, February 6, 2001
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