Screening Mammography: Higher Medicare Payments Could Increase Costs Without Increasing Use
HRD-93-50
Published: Apr 22, 1993. Publicly Released: May 25, 1993.
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Highlights
Pursuant to a congressional request, GAO reviewed the Medicare Program's payment levels and billing procedures for screening mammography, focusing on whether: (1) Medicare payments should be increased so physicians would increase mammography availability by offering it in their offices; and (2) physicians who contract with leasing firms for screening mammography services have problems with Medicare billing procedures.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Health and Human Services | The Secretary of Health and Human Services should review the Department of Health and Human Services' screening mammography education programs for both beneficiaries and physicians and determine whether the programs should be strengthened to encourage more Medicare-eligible women to receive mammograms. |
HHS concurred with the recommendation and has continued to promote screening mammography for Medicare-eligible women.
|
| Department of Health and Human Services | The Secretary of Health and Human Services should require the Administrator, HCFA, to issue guidance to the carriers allowing combined billing for the professional and technical components of screening mammography services provided under package leasing arrangements. |
On September 30, 1994, HHS issued its final rule on Medicare coverage of screening mammography. The rule modified and clarified the billing and payment requirements but did not specifically address billing for services provided under package leasing arrangements.
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Topics
Billing proceduresBreast cancerDisease detection or diagnosisHealth care cost controlHealth care servicesHealth resources utilizationMedical economic analysisMedical equipmentMedical services ratesMedicareMammography