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Mammography pushback continues

This article was originally published in The Gray Sheet

Executive Summary

The American College of Radiology and the Society of Breast Imaging are pressing the Senate to add a specific exclusion for mammography in sections of its health care reform bill that rely on recommendations from the U.S. Preventive Services Task Force. The efforts come in response USPSTF's recent recommendation against routine mammograms in average-risk women aged 40-49 and for only biennial scans after that, which ACR and other clinical groups say are misguided (1"The Gray Sheet" Nov. 23, 2009). Nothing in current law or in the pending health care reform bills would require public or private payers to restrict coverage based on the new recommendations, but ACR worries that various provisions in the Senate reform bill would leave openings in that direction. One provision, for instance, gives CMS authority to modify coverage of certain preventive services "to the extent that such modification is consistent with the recommendations of the [USPSTF]" and others only require private payers and Medicaid to cover preventive services if USPSTF recommends them

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