Osteoporosis Treatment

Impact of Medicare Policy on Patient Access to Quality Osteoporosis Care
On October 9, 2007 a successful national Webcast was hosted entitled “DXA Reimbursement Reductions: Implications for Quality Osteoporosis Care.” The DXA Webcast PowerPoint presentation is now available for viewing (link below). In addition, we invite you to share the these slides with other physicians and your patients in an effort to educate them on this crisis. 

The program was moderated by Ethel Sirus, MD, President of the National Osteoporosis Foundation. Two members from the ISCD Board of Directors participated including Marjorie Luckey, MD who shared her story of the impact of DXA cuts on her Center and Andrew Laster, MD who responded to many questions submitted by the online audience.

Highlights and implications:

• Medicare Physician Fee Schedule changes

• “Deficit Reduction Act” changes

• Reduced reimbursement 75% - from approximately $140 to $35 by 2010

These actions may seriously limit patient access to osteoporosis diagnosis and management using DXA

This information and other resources are also posted in the Grassroots Resources section of the ISCD Advocacy Web site.  The ISCD Advocacy Web site is open to all visitors.  Colleagues and patients can register on the ISCD Advocacy Web site and send letters to Congress with a few mouse clicks.

The DXA Bill is Here - Act Now

Representative Shelley Berkley (D-NV) is introducing the “Fracture Prevention and Osteoporosis Testing Act of 2007.”  The bill will freeze DXA rates at 2006 levels until a study of the effect of these cuts on patient care is completed.  At this time, Rep. Berkley needs the support of her Congressional colleagues to give this bill added momentum.  Please contact your Congressional Representative and urge them to sign on as an original co-sponsor to this important piece of legislation.  Visit the ISCD Advocacy Web site now, login (or register) and “Take Action”.  It only takes a few minutes to help.

ISCD and DXA Task Force Met with CMS Officials Regarding DXA Cuts

On August 28, 2007 representatives from ISCD, NOF, AACE, TES and ACOG met with CMS officials regarding the damaging affects of the DXA cuts on patient care. ISCD Vice-President Dr. Andrew Laster, AACE President Dr. Richard Hellman and staff from the Lewin Group made a presentation aimed at restoring reimbursement for DXA services to appropriate levels. The timing of the meeting was critical; proposed Medicare rules that will continue the 4-year phase in of cuts to central DXA reimbursement will become final in early November 2007. Public comment regarding the proposed rules were due on August 31. In addition to filing formal written comments, ISCD and our partners wanted to make sure that Medicare officials understood the urgency of the problem. We delivered a clear message to CMS: the cuts will effectively dismantle the osteoporosis care infrastructure in the United States and will undermine Medicare prevention efforts.

The meeting focused on the results of a study regarding the cost of performing DXA in the office setting.  ISCD, AACE, TES and ACRheum commissioned the Lewin Group, a premier Washington health care firm, to perform the study which was conducted in July. 163 respondents representing primary care and specialists who perform DXA in the office or non-facility setting submitted complete responses with detailed confidential financial information. The Lewin Group calculated that the median DXA cost per procedure was $134, far exceeding the current rate of reimbursement. Lewin staff presented the following key findings to CMS officials:

• Eighty-six percent of respondents are not reimbursed adequately for DXA under the 2007 fee schedule.
• No physician will be reimbursed adequately for DXA when reimbursement drops to $35 in 2010.
• Proposed legislation to freeze DXA at 2006 rates ($140) would save Medicare $1.145 billion after taking into consideration the savings associated with avoiding future fractures.

On August 31, 2007, ISCD filed formal comments with CMS regarding the cuts to DXA that began in 20007 and will continue to be phased in over the next four years. Click on the link below to view ISCD’s formal comments.  A complete copy of the ISCD comments to CMS can also be found in the Grassroots section of the ISCD Advocacy Web site.  Click here to visit that site now.