May 2010 Update: Read about changes to DXA reimbursement payments.
Summary
Chronic reductions in Medicare reimbursement for osteoporosis screenings have resulted in reduced access to this important service. Section 3111 of the Patient Protection & Affordable Care Act provided relief to physicians who perform preventative osteoporosis testing for 2010-2011. To ensure continued access to this necessary preventative screening, Congress must provide sustained relief for, at a minimum, two additional years (2012-2013).
Osteoporosis Screening Can Reduce Risk of Fractures
Osteoporosis involves a gradual loss of bone, which causes bones to become thinner, more fragile and more likely to break. Due to the complications of fracture, the disease is associated with significant mortality and morbidity. Osteoporosis and low bone mass affect an estimated 44 million Americans.
In order to reduce the impact of osteoporosis, it is important to diagnose it prior to fracture and initiate treatment for those at high risk. Dual-energy x-ray absorptiometry (DXA) is recognized as the "gold standard" for diagnosing osteoporosis and monitoring the response to therapy. Knowledge of bone density and other risks for fracture allows patients and their health care providers to choose preventative or treatment options to reduce risk of future fracture.
Severe Medicare Reductions Hurt Patient Access
Until relief in the ACA, DXA reimbursements drastically decreased between 2006 and 2010, dropping from approximately $148 to $54. The temporary reimbursement increase to 70% of the 2006 Medicare reimbursement level has provided some relief to physicians providing access to this crucial preventative screening. However, physicians and patient groups indicated that these cuts will make it cost-prohibitive to continue to provide these services in physician offices, where twothirds of patients are currently tested.
Congress Should Act to Support Preventive Osteoporosis Screenings
Senators Olympia Snowe (R-ME) and Debbie Stabenow (D-MI) and Representatives Shelley Berkley (D-NV) and Michael Burgess, MD (R-TX) have introduced the Preservation of Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2011 (H.R. 2020/S. 1096). The legislation extends payment for DXA scans at the current reimbursement rate of 70 percent of the 2006 reimbursement level through 2013. Encourage your members of Congress to co-sponsor H.R. 2020/S. 1096 using the ACR Legislative Action Center.
The ACR strongly encourages Congress to support continued relief for osteoporosis screenings by extending the increase for an additional two years.
Supporting Materials
HHS Report on Preventative Services in Older Adults 
