Washington, D.C. – U.S. Senator Susan Collins (R-ME), the Chairman of the Aging Committee, and Senator Ben Cardin (D-MD) led a bipartisan group in urging Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma to improve access to testing for low bone density and osteoporosis for our nation’s seniors. The Senators called on CMS to address dual-energy X-ray absorptiometry (DXA) reimbursement in the final 2021 Physician Fee Schedule rule and to engage in meaningful dialogue with Congress and the stakeholder community to look for ways to ensure appropriate access to DXA tests, which are the gold standard for screening.
“While insufficient Medicare reimbursement hampered access to DXA testing prior to the pandemic, physicians’ ability to continue offering DXA testing for low bone density may all but disappear as a result of the pandemic absent urgent action from CMS,” the Senators wrote. “The COVID-19 pandemic threatens to eliminate what patient access to DXA still remains in the physician office setting.”
“With providers across the country facing tremendous financial challenges as a result of the ongoing crisis, 20 percent of physicians recently surveyed who currently offer DXA testing say that they will discontinue this service because of low reimbursement from Medicare,” the Senators continued. “For the health of Medicare beneficiaries, we urge CMS to address DXA reimbursement in the final 2021 Physician Fee Schedule rule.”
Osteoporosis and its related bone fractures have a staggering impact on the U.S. health care system, accounting for approximately 300,000 hip fracture hospitalizations, with costs projected to grow to over $25 billion by 2025. Because the risk of osteoporosis increases as bones become thinner with age, approximately 44 percent of all women and 25 percent of men over the age of 60 will experience a bone break due to osteoporosis in their lifetime. These high rates of osteoporosis and low bone mass result in over two million related fractures each year in the United States.
In Maine alone, 54% of osteoporosis cases went undiagnosed and untreated in 2017, resulting in more than 32,000 fewer women receiving a DXA scan than projected in 2008, 40 additional hip fractures due to reduced screening, 88 additional hip fracture related deaths, and $17 million in additional Medicare costs to treat hip fractures.
Senators Collins and Cardin introduced the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2018, bipartisan legislation to increase access to osteoporosis screening, while lowering the costs and consequences resulting from a lack of diagnosis. This legislation is endorsed by the American Association of Clinical Endocrinologists, the National Osteoporosis Foundation, and more than forty additional national medical societies and patient advocate organizations.
The letter was also signed by Senators Shelley Moore Capito (R-WV), Kyrsten Sinema (D-AZ), Marsha Blackburn (R-TN), Richard Blumenthal (D-CT), Martha McSally (R-AZ), Jon Tester (D-MT), Robert Menendez (D-NJ), Dianne Feinstein (D-CA), Debbie Stabenow (D-MI), Sherrod Brown (D-OH) and Angus King (I-ME).
Click HERE to read the full letter.