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Senators scratch backs.

August 21, 2009

The Czar, in reading HR3200, drew my attention to Section 1149 “MEDPAC STUDY AND REPORT ON BONE MASS MEASUREMENT“.  Why would a Health Choices Act features such a specific requirement to review a single health assessment and report back to Congress in 9 months?  The same act puts $8,000,000,000 towards improving Medicaid without a single detail (Section 1146).

What’s up with bone mass measurement?  Here’s my guess:  pet project of a senator who offered to support the entire Act if this section were included.

Exhibit 1 —


(a) In General- The Medicare Payment Advisory Commission shall conduct a study regarding bone mass measurement, including computed tomography, duel-energy x-ray absorptriometry, and vertebral fracture assessment. The study shall focus on the following:

    (1) An assessment of the adequacy of Medicare payment rates for such services, taking into account costs of acquiring the necessary equipment, professional work time, and practice expense costs.

    (2) The impact of Medicare payment changes since 2006 on beneficiary access to bone mass measurement benefits in general and in rural and minority communities specifically.

    (3) A review of the clinically appropriate and recommended use among Medicare beneficiaries and how usage rates among such beneficiaries compares to such recommendations.

    (4) In conjunction with the findings under (3), recommendations, if necessary, regarding methods for reaching appropriate use of bone mass measurement studies among Medicare beneficiaries.

(b) Report- The Commission shall submit a report to the Congress, not later than 9 months after the date of the enactment of this Act, containing a description of the results of the study conducted under subsection (a) and the conclusions and recommendations, if any, regarding each of the issues described in paragraphs (1), (2), (3), and (4) of such subsection.

Exhibit 2 —

S.769 – Medicare Fracture Prevention and Osteoporosis Testing Act of 2009

A bill to amend title XVIII of the Social Security Act to improve access to, and increase utilization of, bone mass measurement benefits under the Medicare part B program.

Official summary:

Medicare Fracture Prevention and Osteoporosis Testing Act of 2009 – Amends title XVIII (Medicare) of the Social Security Act, as amended by the Medicare Improvements for Patients and Providers Act of 2008, to direct the Secretary of Health and Human Services to establish a national minimum payment amount for CPT code 77080 (relating to dual energy x-ray absorptiometry, or DXA, the most widely accepted method of measuring bone mass to predict fracture risk) and CPT code 77082 (relating to vertebral fracture assessment, or VFA), and any successor to such codes as identified by the Secretary (bone mass scans). Directs the Secretary to arrange with the Institute of Medicine of the National Academies to study and report to the Secretary and Congress on:
(1) the ramifications of Medicare reimbursement reductions for DXA and VFA on beneficiary access to bone mass measurement benefits; and
(2) the methods to increase use of bone mass measurement by Medicare beneficiaries.

This bill was introduced April 1, 2009 by Senator Blanche Lincoln, Democrat from Arkansas.  After introduction and reading, it was referred to committee and then never heard of again until Section 1149 appeared.


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