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Missouri hands over the bill to demand 3D mammography coverage



Starting next month, all health insurances in Missouri will have to cover 3D mammograms as well as the conventional flat images.

So you need one?

The medical community is not in complete agreement, but consensus is growing among specialists that 3D is the right way to find breast cancer.

"(For) the majority of specialized breast radiologists who read a ton of mammograms day after day show that digital breast tomosynthesis (3D mammography) increases the detection of cancer and decreases false-positive results," says Ruby Meierotto, a radiologist at St. Luke's East Breast Center. "At some point, the 3D mammogram will be the standard of care."

But it is not there yet, which is why some private insurers have not covered it in the past for routine breast exams. Emagazine.credit-suisse.com/app/art … = 1

57 & lang = DE There is disagreement in the community about whether researchers know enough to say definitively that Englisch: emagazine.credit-suisse.com/app/art … = 120 & lang = en the 3D mammograms are better.

Well-known hospitals such as the MD Anderson Cancer Center and the Mayo Clinic are considering their benefits especially for women with dense breast tissue, especially for catching early cancer.

But the National Cancer Institute, a federal consortium of cancer researchers, says that's ahead of the evidence.

"Although many women are offered DBT (Digital Breast Tomosynthesis), it has not yet been conclusively clarified whether 2-D mammography is superior to detecting early cancers and avoiding false-positive outcomes," it says on the website of the institute.

NCI is funding a large-scale clinical trial to provide a clearer answer. It started last year and is expected to last five years.

"I think NCI is always a kind of cautious organization," said Tiffany Lewis, a radiologist at Truman Medical Centers. "I think there are long-term data and studies showing the benefits (of 3D mammograms)."

Lewis said that she discovered cancer on 3D scans almost every day that she would have missed in 2D.

Although 3D mammograms are now covered by the Medicare federal health insurance program, a separate federal advisory group, the US Preventative Services Task Force, has not yet become one of the prevention services that insurers need to cover. Affordable Care Act

In the absence In a federal mandate, some states have prevailed.

Arkansas, Connecticut, Illinois, Maryland, New Jersey, Pennsylvania, and Texas all had one in their books by the end of 2017, according to the American College of Radiology, while Missouri was one of at least seven other states considering bills in 2018 Kansas has not adopted any legislation.

The Missouri Bill, HB 1252, was introduced by the Republican Dean Plocher, a Republican lawyer from St. Louis.

Plocher said it was a "breeze." given the prevalence of breast cancer. He said he did not know that there was still disagreement over whether the 3D scans were better, but said the discussion should be between doctors and patients.

"I think the doctor should have greater input, along with the patient on the course and extent of medical care and not just the insurance company trying to make an end result," said Plocher.

The bill proved not controversial, passed the House 145-2 and the Senate 32-1.

America's Health Insurance Plans, a health insurance trading group, have not opposed it.

The bill also lowers the patient age at which insurers must file annual mammograms of 50 to 40 years the card.

The American College of Radiology recommends annual mammograms from the age of 40 years.

The guidelines of the American Cancer Society call for annual scans starting at 45 and then every two years after 55 years, but the group also says women 40 to 44 should be given the option of a mammogram.

The US Preventive Services Task Force recommends mammograms every two years, beginning at the age of 50, but also states that younger patients should be offered at their discretion.

Although all groups of mammograms are indispensable for the detection of cancer, they do not agree when the risks of false positive and unnecessary medical procedures such as biopsies outweigh the benefits of early detection.

The Missouri bill enters into force on August 28, but insurers will not have to pay the 2D rate until the first few months of 3D mammograms. Depending on their plan, patients may have to pay the difference, which ranges from $ 50 to $ 100.

Insurers must cover full 3D rates from January 1, 2019, as new insurance plans come in with new premiums. Effect

Plocher said he expects the premium effect to be minimal.

Blue Cross and Blue Shield from Kansas City, the region's largest private insurer, began covering the 3D mammograms on July 1st.

Lewis said this was an important step. She said about half of her patients who now have to pay out of the pocket for the 3D scan, instead choose the 2D. The Truman Medical Center is already serving a vulnerable population or patient, and Lewis said older technology needs to be more vulnerable.

"I think it would be fantastic in the future if all mammograms were 3D mammograms," said Lewis. 19659032]
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