Senator Daniel K. Akaka - Speeches and Statements


Measure Garners Strong Bipartisan Support

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 insurers."

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 disease.

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 appropriate increase.

The Akaka bill is the Senate companion measure to H.R. 976, introduced in the House by Representative Neil Abercrombie (D-HI).

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