Radiology leaders are hailing the breast cancer screening guidelines recently adopted by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) under the Affordable Care Act (ACA), which require private insurers to cover regular mammograms for women ages 40 and older, who have an average risk of developing breast cancer, with no copay.
The requirements also apply to patients covered by Medicaid expansion under the ACA.
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The American College of Radiology (ACR), which took part in the process of developing the screening guideline process, along with the Society of Breast Imaging (SBI), issued a statement supporting the coverage.
“Annual screening of women over 40 is the way to save the most lives,” Dr. Debra Monticciolo, chair of the ACR Breast Imaging Commission, told HCB News. “It’s really important that women have support for that.”
The guidelines come after the U.S. Preventive Services Task force (USPSTF) earlier in 2016 issued its final report on breast cancer screening, recommending that women between the ages of 50 and 75 with an average breast cancer risk get mammograms every two years.
The USPSTF has given mammograms for women in their 40s a “C” recommendation, meaning it recommends “selectively offering or providing this service to individual patients based on professional judgment and patient preferences.” The USPSTF said it believed screening in this age group leads to more false positives and unnecessary biopsies.
In general, the ACA only requires private insurers to cover procedures with a “B” recommendation or higher from the USPSTF.
The HRSA guidelines recommend that average-risk women begin breast cancer screening with mammography in their 40s, have a mammogram every year or every two years, and continue screening through at least age 74.
“Women should be able to choose for themselves when to be tested, and to have that decision respected in terms of covered access, said Dr. Elizabeth Morris, president of the SBI, in a statement. “These recommendations help ensure that women continue to have that screening choice.”
Monticciolo said that the new HRSA guidelines are not dependent on the ACA, which Republicans in Congress have supported repealing.