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CMS Should Maintain Focus on Prevention

Type: Get Mad Column
Date: Winter 2006

The Centers for Medicare and Medicaid Services (CMS) is the federal agency that administers Medicare, Medicaid, and related programs, to ensure that beneficiaries are aware of health care services and that these services are accessible. CMS' mission includes a commitment to policies and actions that promote efficiency and quality in health care delivery.

The Centers for Medicare and Medicaid Services (CMS) is the federal agency that administers Medicare, Medicaid, and related programs, to ensure that beneficiaries are aware of health care services and that these services are accessible. CMS' mission includes a commitment to policies and actions that promote efficiency and quality in health care delivery.

In recent years, CMS has demonstrated an increasing focus on disease prevention. Access to routine preventive screenings and vaccinations has improved. CMS has also made strides in educating beneficiaries about the benefits of seeking and receiving preventive care.

Proposed Cuts to Preventive Services

Despite the fact that preventive care helps to reduce overall costs to the health care system and that early diagnoses provide tremendous benefits to individual patients, current CMS proposals would limit the availability of certain procedures related to breast cancer, osteoporosis and shingles.

Some proposals under consideration include:

  • A 50% cut in reimbursement for brachytherapy, a therapy following lumpectomy that significantly reduces treatment time and damage to healthy breast tissue.
  • A 75% cut in reimbursement for DXA, the gold standard for bone density testing. DXA is used in approximately three-fourths of all osteoporosis screening exams
  • A cut in reimbursement to physicians for the administration of the herpes zoster vaccine, which prevents and reduces the severity of shingles. At least 50% of the population over age 80 will get shingles at some time.

Progress Should Not Be Undermined

If implemented, these proposals will undermine progress that has been made to encourage preventive health care, because many beneficiaries will not be able to afford to pay the full cost for these services themselves. Not only will patients suffer personally, but the entire health care system will be further burdened, having to provide for individuals stricken with the later stages of diseases that could have been treated earlier or prevented.

Contact your federal elected officials and ask them to urge CMS to reconsider a change in reimbursement for these procedures and ensure the future strength of the nation's health care system by opposing further cuts to preventive care services.

Contact your:
Member of Congress
U.S. Senator


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