[Congressional Record Volume 145, Number 78 (Thursday, May 27, 1999)]
[Senate]
[Page S6297]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE:
  S. 1152. A bill to amend title 5, United States Code, to ensure that 
coverage of bone mass measurements is provided under the health 
benefits program for Federal employees; to the Committee on 
Governmental Affairs.


   osteoporosis federal employee health benefits standardization act

 Ms. SNOWE. Mr. President, I rise today to reintroduce 
legislation that will standardize coverage for bone mass measurement 
for people at risk for osteoporosis under the Federal Employee Health 
Benefits Program. This legislation is similar to my bill which was 
enacted as part of the Balanced Budget Act to standardize coverage of 
bone mass measurement under Medicare. The bill I reintroduce today 
guarantees the same uniformity of coverage to Federal employees and 
retirees as Congress provided to Medicare beneficiaries two years ago.

  Osteoporosis is a major public health problem affecting 28 million 
Americans, who either have the disease or are at risk due to low bone 
mass; 80 percent of its victims are women. This devastating disease 
causes 1.5 million fractures annually at a cost of $13.8 billion--$38 
million per day--in direct medical expenses. In their lifetime, one in 
two women and one in eight men over the age of 50 will fracture a bone 
due to osteoporosis. Amazingly, a woman's risk of a hip fracture 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 were detected early and treated. Though we 
now have drugs that promise to reduce fractures by 50 percent and new 
drugs have been proven to actually rebuild bone mass, a bone mass 
measurement is the only way to diagnose osteoporosis and determine 
one's risk for future fractures. And we have learned that there are 
some prominent risk facts: age, gender, race, a family history of bone 
fractures, early menopause, risky health behaviors such as smoking and 
excessive alcohol consumption, and some medications all have been 
identified as contributing factors to bone loss. But identification of 
risk factors alone cannot predict how much bone a person has and how 
strong bone is--experts estimate that without bone density tests, up to 
40 percent of women with low bone mass could be missed.
  Unfortunately, coverage of bone density tests under the Federal 
Employee Health Benefit Program (FEHBP) is inconsistent. Instead of a 
comprehensive national coverage policy, FEHBP leaves it to each of the 
nearly 500 participating plans to decide who is eligible to receive a 
bone mass measurement and what constitutes medical necessity. Many 
plans have no specific rules to guide reimbursement and cover the tests 
on a case-by-case basis. Some plans refuse to provide consumers with 
information indicating when the plan covers the test and when it does 
not and some plans cover the test only for people who already have 
osteoporosis.
  Mr. President, we owe the people who serve our Government more than 
that. We know that osteoporosis is highly preventable, but only if it 
is discovered in time. There is simply no substitute for early 
detection. My legislation standardizes coverage for bone mass 
measurement under the FEHBP and I urge my colleagues to support this 
legislation.
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