Weiner, Maloney Push for Increasing Reimbursement Rates
Brooklyn women can wait up to four months just to access basic, cancer-detecting mammograms, a new investigation from Representative Anthony Weiner (D – Brooklyn and Queens), a member of the House Commerce Subcommittee on Health, and Representative Carolyn Maloney (D – Manhattan and Queens) showed.
The investigation of mammogram accessibility surveyed 33 randomly selected public and private health clinics and found that 14 screening facilities had at least a month of wait time – despite the fact that some breast cancers can more than double in size in that time.
Highlights of the Study:
• Citywide average wait for a mammogram is 1 month.
• Wait time for Queens hospitals averaged 4.3 weeks.
• Bronx facilities posted the longest average wait time for a screening – 5.4 weeks.
• Facilities in Manhattan had the shortest time, with an average 1.2 weeks.
• Wait times increased by 1 week at Staten Island facilities since 2008 – from 4.2 weeks to 5.2 weeks.
• Wait times decreased by two weeks at Brooklyn facilities – from 7.4 weeks to 4 weeks since 2008.
• Two facilities posted same day wait times while Wyckoff Heights Medical Center in Brooklyn had over a four-month wait for a mammogram – up 9.5 weeks from 2008.
While the current nationwide average costs for a film mammogram screening is around $125, the 2009 Medicare reimbursement rate is only about $81.51 – leaving health centers to cover a $44 gap. That rate is down from $83.03 in 2008. For a digital mammogram screening, the current average cost is around $175, while the 2009 Medicare reimbursement rate is only $129.84 – leaving health centers to cover a $45 gap.
From 2006-2009, the Centers for Medicare and Medicaid Services reduced Medicare reimbursement rates by 4.8 percent as a result of a 2005 bill passed by the Republican-controlled Congress. The projected 2010 reimbursement rates are at approximately $79 for film screening and $127 for digital screening, leaving facilities with a $46 to $48 overrun.
Rep. Weiner, who passed legislation to increase the Medicare reimbursement rates in 2003, plans to re-introduce legislation to increase reimbursement rates 15 percent in 2010 to $95 for film screenings and $150 for digital screenings – and index the rate in later years. The step will help financially burdened health clinics.
“New Yorkers have the second highest rate of breast cancer in the country – but some of the longest waits for mammograms. Early detection makes all the difference. If you catch breast cancer early, you have a greater chance of living. It’s that simple,” said Rep. Maloney. “I thank my friend Congressman Weiner for releasing this vital report and for his advocacy for increasing mammogram reimbursement rates. When providers lose money performing mammograms, we all lose.”
Rep. Weiner said, "Increasing access to mammograms clearly saves lives. Raising the reimbursement rate will ensure that women have increased options to protect their most important asset – their health.”
To calculate wait times, Rep. Weiner’s staff called 33 mammogram facilities to inquire the earliest appointment for a mammogram.