[Congressional Record Volume 144, Number 105 (Thursday, July 30, 1998)]
[Senate]
[Pages S9436-S9437]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. AKAKA:
  S. 2378. A bill to amend title XVIII of the Social Security Act to 
increase the amount of payment under the Medicare program for pap smear 
laboratory tests; to the Committee on Finance.


             investment in women's health care act of 1998

  Mr. AKAKA. Mr. President, today I introduce the Investment in Women's 
Health Act of 1998, a bill to increase Medicare reimbursement for Pap 
smear laboratory tests. This is the Senate companion measure to the 
bill introduced in the House by my colleague and friend, Representative 
Neil Abercrombie.
  Last year, I was contacted by pathologists who alerted me to the 
cost-payment differential for Pap smear testing in Hawaii. According to 
the American Pathology Foundation, Hawaii is one of 23 states where the 
cost of performing the test significantly exceeds the Medicare payment. 
In Hawaii, the cost of performing the test

[[Page S9437]]

ranges between $13.04 and $15.80. The Medicare reimbursement rate is 
only $7.15.
  This large disparity between the reimbursement rate and the actual 
cost may force labs in Hawaii and other states to discontinue Pap smear 
testing. Additionally, the below-cost-reimbursement may compel some 
labs to process tests faster and in higher volume to improve cost 
efficiency. This situation increases the risk of inaccurate results and 
can severely handicap patient outcomes.
  If the Pap smear is to continues an effective cancer screening tool, 
it must remain widely available and reasonably priced for all women. 
Adequate payment is a necessary component of ensuring women's continued 
access to quality Pap smears.
  My bill will increase the Medicare reimbursement rate for Pap smear 
lab work from its current $7.15 to $14.60--the national average cost of 
the test. This rate is important because it establishes a benchmark for 
many private insurers.
  No other cancer screening procedure is as effective for early 
detection of cancer as the Pap smear. Over the last 50 years, the 
incidence of cervical cancer deaths has declined by 70 percent due in 
large part to the use of this cancer detection measure. Experts agree 
that the detection and treatment of precancerous lesions can actually 
prevent cervical cancer. Evidence also shows that the likelihood of 
survival when cervical cancer is detected in its earliest stage is 
almost 100 percent with timely and appropriate treatment and follow-up.
  Mr. President, an estimated 13,700 new cases of invasive cervical 
cancer will be diagnosed in 1998 and 4,900 women will die of the 
disease. I urge my colleagues to support this important legislation.
  Mr. President, I ask unanimous consent that a list of the average Pap 
smear production costs for 23 states be printed in the Record.
  There being no objection, the list was ordered to be printed in the 
Record, as follows:


                       Pap Smear Production Costs

California.......................................................$18.84
                                                                  17.11
                                                                  17.00
                                                                  13.05
Colorado..........................................................16.94
Connecticut.......................................................16.87
Delaware..........................................................22.00
Florida...........................................................14.00
Georgia...........................................................10.73
Hawaii............................................................13.04
                                                                  14.04
                                                                  15.40
                                                                  15.80
Illinois..........................................................13.12
Iowa..............................................................13.78
Kansas............................................................14.62
Kentucky..........................................................16.00
                                                                  13.01
Maryland..........................................................14.05
Michigan..........................................................13.16
Nebraska..........................................................16.12
New Mexico........................................................20.65
Ohio..............................................................18.46
                                                                  14.15
                                                                  14.50
South Carolina....................................................16.89
                                                                  13.00
South Dakota......................................................10.25
Tennessee.........................................................12.36
Texas.............................................................13.50
Vermont...........................................................18.92
Washington........................................................11.64
                                                                  12.00
                                                                  12.52
                                                                  12.90
                                                                  12.91
                                                                  13.22
                                                                  13.42
                                                                  14.69
Wisconsin.........................................................13.00

Note.--This data was obtained from the American Pathology Foundation.
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