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Mammogram Coverage Won't Change, Companies Say

11:14 AM, Nov 19, 2009   |    comments
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(USATODAY) -- Insurance companies contacted by USA TODAY say they will continue paying for annual mammograms amid widespread fears that new breast cancer screening guidelines from a federal task force could lead women to lose coverage for those tests.

The guidelines - suggesting that most women under 50 don't need routine mammograms and that women over 50 need them only every other year - were issued Monday night by the U.S. Preventive Services Task Force.

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Secretary of Health and Human Services Kathleen Sebelius tried to ease women's fears by affirming her support for mammography and noting that government policy won't change. Medicare is required by law to cover one mammogram for women from 35 to 39 and annual screenings after that. Sebelius can change that coverage after consulting with the head of the National Cancer Institute.

Although task-force experts are government-appointed, "they do not set federal policy and they don't determine what services are covered by the federal government," Sebelius said in a statement.

"I would be very surprised if any private insurance company changed its mammography coverage," she said.

Leaders of the American College of Radiology and the Society of Breast Imaging issued statements Monday that the new recommendations looked like an effort to cut costs.

At least so far, however, insurance plans have not proposed changing their coverage, says Susan Pisano, a spokeswoman for America's Health Insurance Plans, which represents 1,300 companies covering 200 million Americans.

Some of the companies that told USA TODAY that they will continue paying for mammograms for women in their 40s include Kaiser Permanente, Aetna, Cigna, Geisinger Health Plan, Group Health Cooperative and WellPoint, which operates Blue Cross/Blue Shield plans in 14 states.

Together, these plans cover more than 73 million people.

A spokeswoman for Kaiser Permanente, Farra Levin, says, "We believe that focusing on prevention and early detection is critical in improving women's health and saving lives."

That doesn't mean that companies are totally ignoring the task force's advice.

A spokeswoman for WellPoint, Jill Becher, says the company considers the task force's recommendations, but also weighs advice from the American Cancer Society and American College of Obstetrics and Gynecology, which still recommend annual screenings beginning at age 40.

Group Health Cooperative, among others, plans to look at the task force's recommendations next year, says spokesman Michael Foley, but it would still pay for the screening.