Delegates Want to Keep Mammogram Insurance Coverage Age Low


By RACHEL LEVEN

ANNAPOLIS (Feb. 05, 2010) - A Maryland House member is trying to preserve insurance coverage for early breast cancer screenings in the wake of a November report that disputed the usefulness of those tests.

Delegate Donna Stifler, R-Harford, presented a mammogram bill Thursday to the House Health and Government Committee that would require insurers to follow the American Cancer Society's 2010 breast cancer guidelines.

Maryland law follows ACS's most up-to-date recommendations.

The bill was created in reaction to the U.S. Preventive Services Task Force's November report, which stated that women only need mammograms every two years starting at age 50.

The 2010 ACS guidelines state that women in their 20s and 30s may receive mammograms every three years covered by their insurance, nonprofit health service plan, or health maintenance organization. Women in their 40s and beyond should receive annual mammograms covered by insurance.

"It's a what-if bill, it's a preventative bill so that regardless of who runs the (ACS) or who wants to change their mind, it won't matter for women in Maryland," said Stifler.

Stifler fears that, without her bill, ACS might someday change its guidelines or a federal law might be created to alter insurance coverage requirements to match the U.S. Preventive Services Task Force recommendations.

"After seeing those guidelines in November, I don't trust any panel anymore," said Stifler.

ACS volunteer and breast cancer survivor, Elaine Koogler, said she didn't think it was likely that ACS would change the age requirement, with or without the passing of this bill.

While the bill prevents increasing the age requirement for regular mammograms, the bill's sponsor isn't opposed to changing other breast cancer regulations if it is in women's best interest.

An amendment presented as part of the bill would allow guidelines to change if there were new discoveries, new technology, or if the age was lowered by ACS due to new research, said Koogler whose breast cancer was discovered during a routine mammogram when she was in her 40ss.

Many committee members were skeptical. Members questioned panelists why was it necessary to complicate a straightforward policy if it was unlikely the ACS would change the age requirement.

"Her intentions I'm sure are to get women the care they need (but) the law as it stands is clean, is simple, and it works," said Delegate Shane Pendergrass, D-Howard.

The bill to make the state use ACS recommendations was passed just last year, sponsored by Delegate Joseline Pena-Melnyk, D-Prince George's, and 24 other delegates.

Insurance companies weren't perturbed by the recent developments, though. In fact, CareFirst BlueCross BlueShield said the company supports the bill.

"We think the American Cancer Society's guidelines on mammograms... are the appropriate standard for insurers," said Bill Casey, CareFirst vice president of government affairs. "Clinicians have used them for years, and patients trust them."

CareFirst's support doesn't mean the bill is going to pass, especially since the company didn't speak at the hearing and Pendergrass is sure that the bill just clutters a good policy.

"The committee specifically chose ... the ACS guideline for this because we believed they would be in the best interest of Maryland," said Pendergrass. "I'm sure that's what Delegate Stifler is trying to do but it's really already done."

Capital News Service contributed to this report.

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