Medicare Fracture Prevention And Osteoporosis Testing Act of 2007

The name of this bill certainly is a mouthful. While lobbying, we generally called it "The DXA Bill."

The DXA Bill was introduced by Representative Shelley Berkley (D-NV). This legislation restores funding that is vital to preventative service in health care. DXA, also called bone density scanning, is a machine used to measure bone density and bone strength, thus identifying patients who have or are at risk for developing osteoporosis. DXA is also capable of measuring bone density and change over time. Osteoporosis is the only rheumatic disease that is preventable. Knowledge of bone density and other risks for fracture allows patients and their health care providers to choose preventative or treatment options to reduce risk of future fracture.

Background:
In the last 5 year review, a bill was passed that lowered the physician reimbursement on expensive medical scans such as CT scans, MRIs, and CAT scans. The use of these thousand dollar scans was being overused and abused, so by lowering the reimbursement, legislators hoped that, by decreasing the profits made off of these tests, physicians would stop using them when unnecessary. However the DXA scan, the only one of its kind, was incorrectly bundled in with these other medical scans in the cut. Unlike the other scans, DXA only takes 5 minutes, it is not invasive to patients at all, it gives instant feedback, and most of all, it only costs $135 to run, which is usually covered by insurance.

As it stands, physicians who offer the DXA scans only make a few dollars off of each test, but they keep the equipment around because it is such an important test for everyone to have. Many doctors even require their patients to have the scan when they reach a certain age, so if medication such as Fosamax or Boniva is required to prevent osteoporosis or rebuild bone growth, those actions can be taken immediately.

When the reimbursement cuts continue on these medical scans in 2010 (another 75%) a DXA scan will only cost $35 and physicians will actually lose money each time they give the test. There will be no incentive to keep the equipment and patients will not have access to the scans.

Osteoporosis and low bone mass affect an estimated 44 million Americans. The only other way to find out if you have osteoporosis is when a fracture occurs. If the cuts continue on the DXA scans, this is how many Americans will discover that they have thinning bones. It is in legislators' best interests to prevent osteoporosis. Prevention of osteoporosis is critical. Underutilization of bone mass measurement will strain the Medicare budget.More than 61 million people in the US are projected to have osteoporosis or low bone mass in2020 as compared to 43 million in 2002. A woman's risk of dying from the consequences of a hip fracture is equal to her combined risk of death from breast, uterine, and ovarian cancer. If physicians cannot perform bone density scans, the early recognition of this horrifying and expensive disease will be impacted.