Endocrine Insider
November 21, 2007

The Endocrine Society strongly endorses H.R. 4206, the Medicare Fracture Prevention and Osteoporosis Testing Act, introduced on November 15, 2007, by Representative Shelley Berkley (D-NV). If enacted, this legislation would restore physician payments for dual energy x-ray absorptiometry (DXA) and vertebral fracture assessment (VFA) services to their 2006 levels. It would also require the Institute of Medicine to study the ramifications of Medicare reimbursement reductions to patient access to DXA and VFA services.

Under the Deficit Reduction Act (DRA) of 2005, payments for DXA were reduced from approximately $140 in 2006 to $82 in 2007. By 2010, payments for DXA services are expected to be reduced to approximately $35 under the DRA. The Endocrine Society is working with a coalition of other interested organizations to advocate for H.R. 4206, and Society members discussed it with members of Congress during recent Hill visits. In addition, many Endocrine Society members individually contacted their members of Congress, asking them to co-sponsor the legislation. As a result of those efforts and Representative Berkley’s commitment to the legislation, more than 40 other members of the House of Representatives have signed on to become original co-sponsors of the bill.

The position that the payment cuts would decrease patient access to DXA tests is supported by a new study that was conducted by The Lewin Group and sponsored by The Endocrine Society and its coalition partners. The study shows that the cost of performing DXA in an office setting will continue to significantly diverge from reimbursement rates for the service as the DRA cuts are fully implemented in the next few years. According to the survey, the median cost of performing DXA in an office setting was approximately $135 in 2006, just $5 less than the Medicare reimbursement rate for that year and much higher than the $35 reimbursement that physicians are expected to receive in 2010. In fact, 93 percent of physicians queried for the Lewin study stated that they would stop providing the service to patients if the cuts are fully implemented. Click here to read more details of this report.

The results of the Lewin study make clear the vital importance of Representative Berkley’s legislation. Sixty-one million people in the U.S. are projected to have osteoporosis and low bone mass by 2020, and it is critical that the nation maintain and preserve its capacity to treat this costly and debilitating disorder. The Medicare Fracture Prevention and Osteoporosis Testing Act is an important step forward to preserve patient access to cutting-edge life-saving technologies that save money in the overall treatment of osteoporosis.

You can still make a difference to the future of this legislation. If you have not previously done so, please contact your representative and ask him or her to co-sponsor the legislation by clicking the link http://capwiz.com/endocrine/issues/alert/?alertid=10473241.