Bill's Goal Is Coverage Of Breast Cancer Tests

Stifler Would Keep Insurers Paying For Early Screenings

February 09, 2010|By Rachel Leven | Rachel Leven,Capital News Service

A Maryland House member is trying to preserve insurance coverage for early breast cancer screenings in the wake of a November report that disputed the usefulness of those tests.

Del. Donna Stifler, a Harford County Republican, presented a mammogram bill last week to the House Health and Government Committee that would require insurers to follow the American Cancer Society's 2010 breast cancer guidelines.

Maryland law follows ACS' most up-to-date recommendations.

The bill was drafted in reaction to a report in November by the U.S. Preventive Services Task Force, in the Department of Health and Human Services, that said women only need mammograms every two years starting at age 50.

The 2010 ACS guidelines call for women in their 20s and 30s to receive mammograms every three years that would be covered by their insurance, nonprofit health service plan or health maintenance organization. Women in their 40s and beyond should receive annual mammograms covered by insurance.

"It's a what-if bill, it's a preventative bill so that regardless of who runs the [ACS] or who wants to change their mind, it won't matter for women in Maryland," Stifler said. She fears that ACS might someday change its guidelines or a federal law might be created to alter insurance coverage requirements to match the U.S. Preventive Services Task Force recommendations.

"After seeing those guidelines in November, I don't trust any panel anymore," Stifler said.

Elaine Koogler, an ACS volunteer and breast cancer survivor, said she didn't think it was likely that ACS would change the age requirement, with or without the passing of this bill.

While Stifler's bill would prohibit increasing the age requirement for regular mammograms, she isn't opposed to changing other breast cancer regulations if it is in women's best interests.

Some committee members were skeptical. Members questioned panelists why was it necessary to complicate a straightforward policy if it was unlikely the ACS would change the age requirement.

"Her intentions I'm sure are to get women the care they need, [but] the law as it stands is clean, is simple and it works," said Del. Shane E. Pendergrass, a Howard County Democrat.

Insurance companies weren't perturbed by the recent developments, though. In fact, CareFirst BlueCross BlueShield said the company supports the bill.

"We think the American Cancer Society's guidelines on mammograms ... are the appropriate standard for insurers," said Bill Casey, CareFirst vice president of government affairs. "Clinicians have used them for years, and patients trust them."

CareFirst's support doesn't mean the bill is going to pass, especially since a company representative didn't speak at the hearing and Pendergrass feels that the bill clutters a good policy.

"The committee specifically chose ... the ACS guideline for this because we believed they would be in the best interest of Maryland," Pendergrass said. "I'm sure that's what Delegate Stifler is trying to do, but it's really already done."

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