AKAKA INTRODUCES LEGISLATION TO PROTECTMeasure Garners Strong Bipartisan Support
QUALITY CANCER SCREENING
May 13, 1999
Washington, D.C. -- U.S. Senator Daniel K. Akaka (D - Hawaii) today
introduced legislation to preserve high quality medical services for women
by increasing the minimum Medicare payment for Pap smear laboratory
screening. The measure, the Investment in Women's Health Act of 1999,
would raise the Medicare reimbursement rate from $7.15 per test to
$14.60--the national average cost of the test. Senators Olympia Snowe
(R-ME), Patty Murray (D-WA), and Susan Collins (R-ME) are lead cosponsors
of the legislation.
The legislation addresses concerns raised by pathologists who briefed
Senator Akaka on the cost-payment differential for Pap smear testing in
Hawaii. According to the American Pathology Foundation, Hawaii is one of
23 states where the cost of performing the test significantly exceeds the
Medicare payment. In Hawaii, the cost of performing the test ranges
between $13.04 and $15.80.
"If the Pap smear is to continue as an effective cancer screening tool,
it must remain widely available and reasonably priced for all women,"
Senator Akaka said. "Fair reimbursement is a necessary component of
ensuring women's continued access to quality Pap smear screening.
"The disparity between the reimbursement rate and the actual cost could
force labs in Hawaii and other states to discontinue Pap smear testing.
Below-cost-reimbursement may compel some labs to process tests faster and
in higher volume to improve cost efficiency. This situation increases the
risk of inaccurate results and can severely handicap patient outcomes. My
bill will increase the Medicare reimbursement rate for Pap smear lab work
from its current $7.15 to $14.60--the national average cost of the test.
This rate is important because it establishes a benchmark for many private
The Pap smear is the most effective cancer screening procedure for the
early detection of cancer. Over the last 50 years, the incidence of
cervical cancer deaths has declined by 70 percent due in large part to the
use of this cancer detection measure. Experts agree that the detection and
treatment of precancerous lesions can actually prevent cervical cancer.
Evidence also shows that the likelihood of survival when cervical cancer
is detected in its earliest stage is almost 100 percent with timely and
appropriate treatment and follow-up.
An estimated 12,800 new cases of invasive cervical cancer will be
diagnosed in the United States in 1999 and 4,800 women will die of the
In 1998, Senator Akaka was successful in having language inserted in
the omnibus budget bill acknowledging the large disparity between the test
costs and Medicare reimbursement. The conference report urged the Health
Care Financing Administration to increase Medicare reimbursement for Pap
smear screening. While HCFA has indicated a willingness to increase this
payment, the legislation specifies what its sponsors believe to be an
The Akaka bill is the Senate companion measure to H.R. 976, introduced
in the House by Representative Neil Abercrombie (D-HI).