The American College of Radiology (ACR) has endorsed the Safeguard Access to Preventative Services Act (H.R. 4794), which was introduced into the U.S. House of Representatives by Rep. Leonard Lance (R-NJ) and three original co-sponsors on March 9.
The bill prohibits the use of any recommendation of the U.S. Preventive Services Task Force (USPSTF), or any successor task force to deny or restrict coverage of an item or service under a federal healthcare program, a group health plan, or a health insurance issuer and for other purposes.
Citing the recent controversial Task Force recommendations for mammography screening, James H. Thrall, MD, FACR, and chair of the ACR Board of chancellors said: “This legislation would help ensure that the recommendations of a small group of individuals, who may not have expertise in the subject on which they are making critical judgments, cannot be used as an excuse to cut costs at the expense of patients.”
As it stands currently, the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) granted the U.S. Department of Health and Human Services permission to consider USPSTF recommendations for Medicare coverage decisions and cost-saving measures. Private insurers may also incorporate the USPSTF recommendations.
Thrall continued, “Simply allowing a small group of people, who may or may not have expertise in the particular subject matter, to publish periodic recommendations in a medical journal or via a web posting, and have those recommendations serve as health coverage policy is unacceptable and potentially dangerous.”
In determining coverage, section 2709 of the bill states that the medical guidelines and recommendations of relevant professional medical organizations may be consulted, including:
- The American Society of Clinical Oncology;
- The American College of Surgeons;
- The American College of Radiology;
- The Society of Breast Imaging;
- The American College of Radiation Oncology; and
- The American College of Obstetricians and Gynecologists.
“USPSTF actions are not always correct,” concluded Thrall. “The USPSTF process needs to be fundamentally changed in order to make sure that patients get the care they need. This bill is a significant step in a sensible direction.”