Something just doesn't add up. Public statements from policymakers about mammography screening don't reflect the content of the Senate health care bill.

The American College of Radiology found language in the proposed bill that supports a government panel's controversial guidance on coverage decisions. ACR informed DOTmed News that a little-known provision buried within the Senate health care reform proposal suggests that Medicare and Medicaid would only be required to cover services receiving a specific grade from the U.S. Preventive Services Task Force. (See DM 10840.)

This suggests an inherent conflict in either understanding or intent on the part of lawmakers who say they oppose the restricted mammography coverage recommendations.

For example, Senate Majority Leader Harry Reid (D-NV) indicated that U.S. Preventive Services Task Force (USPSTF) recommendations would not guide coverage under the health care reform bill, which is about to be debated in the Senate.

"Mammograms save lives," Reid said. "It's the reason why the Senate's health insurance reform bill makes prevention a priority....the task force's recommendation will have absolutely no impact on the bills we in the Senate write, debate or vote on."

Reid echoed assurances from the executive branch. "There is no question that the U.S. Preventive Services Task Force recommendations have caused a great deal of confusion and worry among women and their families across this country," said Health and Human Services Secretary Kathleen Sebelius. "The USPSTF is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don't determine what services are covered by the federal government."

Dispelling Confusion

Are policymakers not aware of the specifics of the bill? Does USPSTF have more clout than lawmakers realize? Perhaps the matter will be addressed shortly.

The latest news is that Chairman Tom Harkin (D-IA) of the Senate Health, Education, Labor and Pensions Committee (HELP) will hold a hearing on the recent task force recommendations for mammography screening, according to ACR.

"On Tuesday, 22 members of the Senate wrote a bipartisan letter to HELP Chairman Harkin asking that the committee look into the situation and try to dispel the confusion that has ensued," ACR reported.

The controversial USPSTF recommendations were against screening for women 40-49, other than high-risk women, and against annual screening for women 50-74, instead favoring screening every other year. It was also against screening those over 74.

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