Congress included access to imaging care protections for the most sick and injured of Medicare beneficiaries and women seeking mammograms in the Consolidated Appropriations Act. The legislation was passed by Congress and signed into law by the President on December 18, 2015.
The Protecting Access to Lifesaving Screenings Act (PALS Act) primary language included in the bill will continue mandatory mammography insurance coverage for millions of women nationwide and help providers continue to save tens of thousands of lives each year. The PALS Act provision delays implementation of U.S. Preventive Services Task Force (USPSTF) draft breast cancer screening recommendations for two years.
The Affordable Care Act (ACA) requires private insurers to cover exams or procedures given a grade of “B” or higher by the USPSTF. The Task Force gave routine screening of women ages 40–49 a grade of “C” and gave a “B” grade only to biennial (every other year) screening for women 50–74. This would indicate that women ages 40–49 who choose routine screening and those 50–74 who want to be screened annually would not be guaranteed coverage if these draft recommendations were implemented. This would particularly impact women in under-served and rural areas.
The protections in this legislation allow women ages 40-and-over who choose to get an annual screening mammogram to be covered, with no copay, for these lifesaving exams. The bill also allows time for breast cancer experts to properly vet the USPSTF recommendations and the process by which they were created as well as more recent literature on mammography screening. This will help ensure sensible screening policy that saves the most lives and minimizes any viable screening concerns.