Voices of Experience · Webinar
Episode 7August 2024

Advocacy and Legislation in Breast Cancer Screening

Screening coverage is being decided in two places at once: a federal task force grade, and a run of state laws.

Hosted by Dianne Keen  ·  with Kit Crancer and Miranda Franco
Guests
Kit Crancer
Kit Crancer
Senior VP of Public Policy at RAYUS
Miranda Franco
Miranda Franco
Senior Policy Advisor at Holland & Knight
The takeaway

A patient who puts off follow-up imaging because of what it will cost her is the clearest evidence in the room.

20+ states
Have passed diagnostic coverage laws
$1,100
The average breast MR cost the Komen foundation estimates
20%
Of those women simply do not come back
2002-2009
When the task force decisions came under scrutiny
The recap

Where breast screening policy actually gets decided

In this Voices of Experience webinar, Dianne Keen is joined by Kit Crancer, Senior VP of Public Policy at RAYUS and immediate past president of RBMA, and Miranda Franco, Senior Policy Advisor at Holland & Knight, for a working session on the policy shaping access to breast cancer screening. They open on the reimbursement pressure sitting underneath every access-to-care conversation, and on the coalition work being done to put evidence rather than sentiment in front of Congress and CMS.

From there the discussion moves to the gap patients feel most directly: the difference between a screening exam and the follow-up imaging that dense breast tissue or a personal history makes necessary, and what it costs a patient when that follow-up is billed as diagnostic. Kit and Miranda walk through the federal density notification requirement, the state coverage laws now on the books in more than twenty states, the Find It Early Act, and the prior authorization reforms changing how fast a payer has to answer.

In this episode

Four things worth your time

Evidence Instead of Sentiment: How the Radiology Patient Action Network, working with the medical imaging manufacturers, polled Medicare beneficiaries on whether they are driving further, changing doctors and waiting longer, and how that data is then used with Congress and CMS.
Screening, Diagnostic, and the Word In Between: Why the panel argues follow-up imaging for dense breast tissue is essential rather than secondary, and why the label decides what the patient pays.
Density Notification Goes Federal: What the updated FDA requirement changes for centers already operating under a state law, and what it changes for everyone else.
Prior Authorization, State by State: The reforms gaining ground, including decision deadlines and a genuine peer-to-peer review with a clinician who knows the modality, and where the panel expects movement next.

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