In a policy statement, the American College of Radiology and Society of Breast Imaging recently urged Congress to pass the Protecting Access to Lifesaving Screenings (PALS) Act (H.R. 3339) , which would ensure that women who want to get regular mammograms retain insurance coverage with no copay.
According to the societies, the legislation would avert thousands of unnecessary deaths resulting from implementation of draft United States Preventive Services Task Force (USPSTF) breast cancer screening recommendations. Introduced by Reps. Renee Ellmers (R-NC) and Debbie Wasserman Schultz (D-Fla), the PALS Act would delay implementation of these recommendations for two years.
“The two-year delay allows consideration of recent large studies that showed mammography to be far more effective than the old studies the USPSTF analyzed,” said Debra Monticciolo, chair of the ACR’s Breast Imaging Commission. “It also provides time for Congress to enact separate legislation that mandates a badly needed overhaul of the closed and outdated USPSTF process.”
The Affordable Care Act requires private insurers to cover exams without patient cost sharing given a grade of “B” or higher by the USPSTF. The task force gave routine screening of women ages 40-49 a “C” grade and gave a “B” grade only to biennial (every other year) screening for women 50-74. This would indicate that women ages 40-49 that choose routine screening and those 50-74 who want annual screening would not be guaranteed coverage.
“The closed USPSTF process does not meet Institute of Medicine (IOM) standards for ‘trustworthy’ guidelines creation and needs updating,” said Elizabeth A. Morris, president of the Society of Breast Imaging.. These USPSTF mammography recommendations are suspect until ACR and SBI recognized experts are included in a meaningful way in their creation.”