HCFA issues rule for mammography screening

Manufacturers of high-end mammography systems may benefit froma federal rule setting standards for equipment to be used in screeningmammography reimbursed by Medicare. The Health Care FinancingAdministration (HCFA) rule issued earlier this month lists equipmentrequirements that match those of the American College of Radiology(ACR) mammography accreditation program. The ACR program was establishedin 1987.

Stringent standards could boost sales for vendors as serviceproviders scramble to upgrade their equipment.

"There are people doing mammography who are not at theforefront of technology," said Robert Coe, vice presidentof engineering at Bennett X-Ray, a mammography manufacturer (SCAN12/26/90). "Better equipment means earlier diagnosis, filmsthat are easier to read, and less chance of error." Bennettoffers a written guarantee that its mammography equipment willmeet ACR accreditation standards, he said.

The new federal rule also limits Medicare payments for thescreening examinations to physicians certified by the AmericanBoard of Radiology, the American Osteopathic Board of Radiology,or an appropriate program as determined by the secretary of theDepartment of Health and Human Services (DHHS).

The rule is only an interim measure. HCFA will accept commentsuntil March 1, before final regulations are issued. The ACR isstudying the rule and may recommend further tightening of thequality requirements.

The Budget Reconciliation Act of 1990 mandated that criteriabe established defining who can perform the Medicare exams andwhat equipment can be used in a screening mammography program.The legislation caps federal payment for each exam at $55.

The National Electrical Manufacturers Association (NEMA) supportedthe legislation. "We thought it was a good idea to providethese monies for people over 65 years old," said Robert Britain,manager of the NEMA diagnostic imaging and therapy systems division.NEMA has not yet formulated a position on what standards shouldbe applied to equipment used in screening exams.

Association members will meet in February to discuss that topic,particularly in regard to federal legislation now on Capitol Hillthat would further define the quality standards for mammographyequipment and its operation.

The proposal authorizes the DHHS to establish minimum qualityassurance procedures for mammography screening and requires theuse of dedicated mammography equipment for the examinations. Thelegislation would also establish specific training standards forthose who conduct and interpret mammography examinations. It wasintroduced last year by Sens. Barbara Mikulski (D-MD) and BrockAdams (D-WA), and resurrected in the current session.