[Congressional Record Volume 141, Number 129 (Friday, August 4, 1995)]
[Extensions of Remarks]
[Page E1626]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                              OSTEOPOROSIS

                                 ______


                       HON. CONSTANCE A. MORELLA

                              of maryland

                    in the house of representatives

                        Thursday, August 3, 1995
  Mrs. MORELLA, Mr. Speaker, osteoporosis is a major public health 
problem affecting 25 million Americans, 20 million of whom are women. 
The disease causes 1.5 million fractures at a cost of $10 billion 
annually in direct medical expenses. One in two women and one in eight 
men over the age of 50 will fracture a bone due to osteoporosis. A 
woman's risk of osteoporosis is equal to her combined risk of 
contracting breast, uterine and ovarian cancer.
  Osteoporosis is largely preventable and thousands of fractures could 
be avoided if low bone mass was detected early and treated. However, 
identification of risk factors alone cannot predict how much bone a 
person has and how strong or weak bone is. Experts estimate that 
without bone density tests, up to 40 percent of women with low bone 
mass could be missed--an unacceptable diagnostic error rate.
  Unfortunately, Medicare's coverage of bone density tests is 
inconsistent. The program covers several types of tests such as single 
photon absorptiometry, measurement of the wrist and radiographic 
absorptiometry, hand; however, it leaves the decision to the Medicare 
carriers whether to cover quantitative computed tomography, spine, and 
dual energy x-ray absorptiometry or DXA--spine, hip, and total body--
one of the most common methods used by scientists. The Food and Drug 
Administration has approved all of these methods except the 
radiographic absorptiometry.
  Medicare covers DXA in 42 States, while parts of four additional 
States are covered. This leaves four States and the District of 
Columbia without coverage. A national average allowable charge of $124 
was established for DXA by the Health Care Financing Administration 
this year, yet a national coverage decision does not exist.
  Inconsistency of coverage policy is confusing and unfair to 
beneficiaries. If a Medicare beneficiary lives in Florida, DXA is 
covered; if she lives in New Jersey, it is not covered. If she lives in 
Baltimore County in Maryland, it is covered; if she lives in Montgomery 
County, MD, it is not covered.
  Today, I am introducing a bill, together with Congresswomen Nita 
Lowey and Eddie Bernice Johnson, as well as 10 other original 
cosponsors, to standardize Medicare's inconsistent coverage of bone 
density tests--the only sure method to determine bone mass and avoid 
some of the 1.5 million fractures caused annually by osteoporosis. The 
bill would also clarify that Medicare will cover other scientifically 
proven techniques to detect bone loss, such as biochemical markers. 
These inexpensive lab tests can be important adjuncts to bone mass 
measurement in the effort to detect and treat individuals who are at 
risk of osteoporosis. Considering that bone density tests are already 
covered by a large majority of the Medicare carriers, this bill will 
not add significantly to the costs of the Medicare program.
  I urge my colleagues to join us in introducing this bill to help 
women and men prevent fractures caused by osteoporosis.


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