Medicare coverage of supplemental imaging would close coverage gaps for women and save lives in states without laws that cover additional imaging, according to the Advanced Medical Technology Association (AdvaMed).
In a letter to the Centers for Medicare and Medicaid Services (CMS) November 1, AdvaMed president and CEO Scott Whitaker noted that Medicare coverage policies should include breast density -- defined as tissue mammographically demonstrated as category C (heterogeneously dense) or category D (extremely dense) -- and that these categories indicate the need for coverage of supplemental breast imaging in addition to screening mammography.
Medicare’s lack of coverage of supplemental imaging technologies for women with dense breast tissue leaves those who lack gap coverage to either pay out of pocket or to forgo potentially life-saving additional testing, according to the letter.
"This is an unacceptable barrier, especially given recently enacted FDA requirements that women be notified about their breast density and the inherent risk of dense breast tissue," Whitaker said. "Additional payment can be a deterrent to women getting the follow-up imaging they may need."
