Missouri to require coverage of 3D mammograms
The Kansas Insurance Department put out an official bulletin Wednesday saying it will require all health insurers to cover 3D mammograms starting next year.
The move comes after Missouri legislators voted to enact a similar policy, joining at least seven other states.
The Kansas Legislature hasn’t touched the issue, but the insurance department decided to use its regulatory authority to make the change.
“This modern technology is providing physicians with great opportunities to diagnose and treat breast cancer more quickly,” assistant insurance commissioner Clark Shultz said in an announcement about the move.
There’s some disagreement on that within the medical community.
Radiologists who read and interpret mammograms largely believe that the 3D scans, also known as digital breast tomography, or DBT, increase early detection rates and decrease false positives, especially for women with dense breast tissue.
But the National Cancer Institute and the U.S. Preventive Services Task Force say there’s not enough evidence yet to make that conclusion. Large-scale multiyear studies are ongoing.
Regardless, starting Jan. 1, 2019, all Kansas insurance plans will have to cover the scans, and most will have to do so at no cost to the consumer.
“This is a win-win for both the patient and the physician,” Shultz said. “It is taking advantage of modern healthcare technology at no additional cost to the patient.”
Bob Hanson, a spokesman for the insurance department, said via email that the department had been in discussions with insurers about a 3D mammography mandate since February.
Cathryn Donaldson, a spokeswoman for America’s Health Insurance Plans, said health insurers want everyone to get proper preventive care because it keeps people healthy and that keeps the insurers’ costs down.
But she pointed to the USPS Task Force’s guidance that says there is not enough evidence to prove 3D mammograms produce better outcomes than traditional mammograms, which generally cost $50 to $100 less.
“When it comes to the significant cost of treatment, we are sensitive to the fact that Americans are continuing to see their health care costs rise exponentially,” Donaldson said via email.
“Moving forward, we’ll continue to work closely with state and federal regulators to ensure we’re improving access to critical preventive services while also protecting overall affordability for patients and taxpayers.”