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Changes in Medicare Could Prevent Fractures

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Legislation that would reverse Medicare cuts for osteoporosis testing is now working its way through Congress.

“The Medicare Fracture Prevention and Osteoporosis Testing Act of 2009” was introduced by Senators Blanche Lincoln (D-AR) and Olympia Snow (R-ME). Two congressmen have sponsored the same measure in the House. If passed, the act will reinstate Medicare reimbursement for an imaging procedure that’s considered the most effective method for osteoporosis diagnosis, known as Dual Energy X-ray Absorptiometry, or DXA.

“Osteoporosis is a silent disease the often goes undetected until a fall or other injury results in a broken bone,” said Representative Shelley Berkley (D-NV), who supported the bill and suffers from the disease. “The utilization of DXA testing is one of the best ways we have to help prevent osteoporosis-related fractures, which are costly and can be devastating to the overall health of older patients.”

Reduced Medicare coverage for the procedure began in 2006, leading some doctors to cut back on providing it. DXA is considered one of the most effective tools for identifying bone disease, and in turn, preventing fractures. Naturally, limiting the public’s access to top diagnostic technology adversely affects its ability to get treatment. According to the National Institutes of Health, about 10 million Americans over age 50 suffer from osteoporosis. And 34 million more have low bone mass, putting them at high risk for the disease.

The low reimbursement rate for DXA applies to non-hospital settings, which means that Medicare patients have to visit multiple providers in order to get more of the cost covered. That has proven difficult for the elderly, frail, and those in isolated or rural regions.

By restoring a greater cost coverage for the procedure, the government can actually save money. One research group estimates that providing the increased coverage could save the Medicare program over $1 billion dollars over five years when considering reduced costs of bone fractures.

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Update: Both versions of this legislation are sitting in separate House and Senate committees for consideration. The bad news is most legislation never makes it past this stage, and this measure has already failed in past congressional sessions. Follow the links to see if your congressmen or senators are on any of the decision making committees. If they are, you might want to drop them a line urging them to push this legislation forward.

May 1, 2009 - 9:33pm

Thank you for sharing this information. It's long past due that the health insurance industry, Congress and Medicare should be focused on preventive care, rather than reactive care. Our elderly typically live on fixed incomes (these days, dwindling faster than ever before) and desperately need legislative help to control the cost of healthcare. Let's hope that there are more moves like this to come from Congress.

April 30, 2009 - 6:54pm
EmpowHER Guest

good news!

April 30, 2009 - 6:24pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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