[Congressional Record Volume 145, Number 34 (Thursday, March 4, 1999)]
[Extensions of Remarks]
[Pages E355-E356]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                INVESTMENT IN WOMEN'S HEALTH ACT OF 1999

                                 ______
                                 

                         HON. NEIL ABERCROMBIE

                               of hawaii

                    in the house of representatives

                        Thursday, March 4, 1999

  Mr. ABERCROMBIE. Mr. Speaker, I rise today to re-introduce the 
Investment in Women's Health Act. I am re-introducing this bill with 
Congresswoman Mary Bono and the support of the National Cervical Cancer 
Coalition, the College of American Pathologists, and the American 
Society of Clinical Pathologists.
  Last year, Dr. James Navin from Straub Hospital visited my office to 
alert me to a very serious inequity in the pap smear reimbursement rate 
in Hawaii. Health insurers in Hawaii had apparently taken a cue from 
the Health Care Financing Administration (HCFA) and lowered their pap 
smear reimbursement rate. Under this lower rate, the local laboratories 
would lose a significant amount of money on each screening. In fact, 
the reimbursement rate was low enough to force the laboratories to 
consider getting out of the business completely. Fortunately, the 
laboratories were able to convince the health insurers of the need for 
increased reimbursement. The laboratories were then compensated with a 
break even reimbursement rate for the pap smears.
  I soon found out that the low reimbursement rate is not only a 
problem in Hawaii, but across the entire United States. The low rate of 
Medicare reimbursement for pap smears has an impact on the rates paid 
by third party payers who peg their payments on what the government 
pays.
  To address the deficiency, I introduced legislation last year to 
raise HCFA's reimbursement rate for pap smears. Due to wide spread 
support, progress on this issue was made with the inclusion of report 
language in the Omnibus bill for fiscal year 1999 urging HCFA to use 
its existing statutory authority to raise the reimbursement rate by 
administrative action.
  Unfortunately, the reimbursement rate has not increased and the time 
table for any change is unclear. In order to rectify this situation, my 
legislation defines the date for an increase in the pap smear 
reimbursement rate and sets the rate at the national average for 
production costs. For women in Hawaii and the rest of the nation, this 
means we can assure their access to reliable and timely pap smear 
results.
  Everyone knows that pap smears save lives. With annual screening, the 
chance of developing cervical cancer can be reduced to less than 1%. 
Over the last 40 years, the incidence of invasive cervical cancer has 
decreased significantly due to early detection efforts. Still, an 
estimated 13,700 new cases of invasive cervical cancer will be 
diagnosed in 1998, and 4,900 women will die of the disease. Screening 
for cervical cancer allows doctors to catch the disease in its early 
stages and save a life. A 70 percent decline in deaths due to cervical 
cancer in the last 50 years can be directly attributed to pap smears.
  An adequate pap smear reimbursement level demonstrates respect for 
the women and

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families who benefit from a timely and accurate annual pap smear. I am 
anxious to continue the work we have begun with HCFA and am counting on 
my colleagues support for the Investment in Women's Health Act of 1999.

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