CSMS Reiterates Strong Support for Breast Tomosynthesis Coverage

During the 2016 legislative session, CSMS strongly supported HB 5233, which would require health insurance coverage for screening mammograms provided by breast tomosynthesis (also called 3D mammography).

CSMS Immediate Past President Robert Russo, MD submitted testimony on behalf of the Medical Society to the Insurance Committee during the 2016 session. CSMS member Liane Philpotts, MD also submitted testimony as an individual. The bill passed the House 139-3, and had unanimous support in the Senate (36-0).

Since the bill’s passage, there has been some confusion about whether the bill would constitute a new state health mandate in excess of essential health benefits (EHB), and concerns that Governor Malloy might veto the bill.

On May 9, House Minority Leader Rep. Themis Klarides held a bipartisan press conference urging support for the bill. She referenced a legal opinion which found that:

  • Breast tomosynthesis is a form of screening mammography, and screening mammography is a State-required benefit enacted on or before 12/31/11.
  • For women ages 40+, screening mammography provided by breast tomosynthesis is a preventive health service required to be included in EHB. Click here to view the full finding.

As the largest group representing Connecticut physicians, CSMS was invited to attend the press conference by Rep. Klarides. She also invited CSMS members Liane Philpotts, MD and Jean Wiegert, MD to provide a clinical perspective on the importance of  breast tomosynthesis.

Screenings using breast tomosynthesis (also called 3D mammography) provide up to 40% fewer false positive results, improved detection of invasive cancers, reduced need for diagnostic mammograms, and improved positive predictive value of biopsies.

With concern over a potential veto by Governor Malloy, CSMS physician leaders have reinforced their support for the bill.

The change in breast imaging technology today is similar to the shift from analog to digital mammography in the early 2000s. “It’s scientific evolution,” said Robert D. Russo, MD, a Fairfield radiologist and past president of CSMS. “We cannot pretend that anything less is satisfactory when it comes to conquering this killer of the women in our families.”

CSMS President-Elect Jeffrey A. Gordon, MD, a Woodstock oncologist, agreed that tomosynthesis  provides a better way to image a woman’s breast, “improving the chances of finding something that needs to be treated and decreasing false findings that create more testing and anxiety.” He observed that the bill “responsibly requires that 3D mammography, already in use across the US, be covered by medical insurance when a patient and her physician chose to do this test.”

CSMS Councilor at Large Kathleen LaVorgna, MD expressed concern that in many cases women’s health is disproportionately affected by cuts to healthcare coverage. Dr. LaVorgna, a Norwalk breast surgeon, noted that “Lack of coverage [for breast tomosynthesis] will create a disparity in receiving evidence-based quality care.”

The Connecticut State Medical Society urges Governor Malloy to sign HB 5233, and ensure that the women of Connecticut have access to this life-saving screening technology.

 

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