Protecting Patient Access To Osteoporosis Testing By Reversing Cuts In Medicare Reimbursement

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Osteoporosis Testing

In an effort to protect patient access to osteoporosis testing and reduce the physical and economic burden of osteoporosis for millions of Americans, Congress introduced H.R. 4206 "Medicare Fracture Prevention and Osteoporosis Testing Act of 2007," sponsored by Congresswoman Shelley Berkley (D-1st-NV) and supported by 41 original cosponsors.

The bill calls for the reversal of drastic cuts in Medicare reimbursement for Dual Energy X-ray Absorptiometry, DXA, the imaging procedure accepted as the gold standard for diagnosing osteoporosis. This legislation builds on federal initiatives already in place to increase fracture prevention efforts and improve the prevention, detection and treatment of osteoporosis.

Medicare reimbursement for DXA has been cut to levels substantially below the cost to perform the procedure. As a result, many physicians, clinics and mobile services around the country are discontinuing this critical health service -- greatly reducing the public's access to the test and jeopardizing patients' quality of care.

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This creates unnecessary barriers for those who cannot take the time for multiple healthcare provider visits and poses a serious threat to the frail and elderly who cannot travel long distances, particularly those living in rural areas. According to estimates, less than 14 percent of those who are eligible are being tested for osteoporosis; by passing this bill we can prevent this number from plunging even lower.

"In the U.S. today, one in two women and one in four men 50 and over will break a bone due to osteoporosis. We need Congress to pass this legislation in order to assure that access to testing is preserved and that those at risk of devastating and costly fractures are diagnosed and properly treated to prevent fractures," said Ethel Siris, M.D., president of the National Osteoporosis Foundation.

A recent study completed by The Lewin Group finds that restoring DXA reimbursement to the 2006 levels will save the Medicare program $1.14 billion over five years due to the reduced number of osteoporotic fractures. DXA is a key tool in identifying those at risk for osteoporosisand helping those with the disease monitor their bone health. It is a recognized, reliable tool for preventing and reducing costly fractures, which account for $18 million in national costs of direct care and are projected to increase by 50 percent over the next two decades, reaching $25.3 billion in 2025.

Osteoporosis now causes an estimated 2 million fractures each year and often results in immobility, pain, placement in a nursing home, isolation and other health problems -- conditions and circumstances that could largely be prevented through proper bone density testing and diagnosis.

The National Osteoporosis Foundation applauds Representative Berkley and all of the cosponsors for introducing H.R. 4206 "Medicare Fracture Prevention and Osteoporosis Testing Act of 2007" and we ask Congress to pass this bill and support access to care for the 10 million individuals with osteoporosis and the 34 million individuals estimated to have low bone mass across the country.

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