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Health: PA Insurers Must Cover All Mammograms With No Co-Pays

By Stephanie Stahl

PHILADELPHIA (CBS) -- All mammograms will now be covered by insurance in the state of Pennsylvania, including mammograms using more advanced technology. Pennsylvania Gov. Tom Wolf's new policy says insurers must now cover all screening mammograms, including the 3D versions, at no out-of-pocket cost to consumers.

Three-dimensional mammography, also known as tomosynthesis, can detect hard-to-find breast cancer that's missed with traditional screenings.

"It takes multiple, very low-dose X-rays of the breast at different angles, and then those are reconstructed into a breast," said Dr. Deborah Copit, a radiologist with Marion-Louise Saltzman Women's Center at Einstein Medical Center. "Then we can sort of slice through, like a loaf of bread."

Dr. Copit says research shows 3D mammograms find 41 percent more cases of invasive breast cancer, and they also reduce the number of false positives.

"I've been working with other radiologists who believe in this technology, trying to explain to insurers how vital this is to the detection of breast cancer," said Dr. Copit.

Even though the American College of Radiology declared 3D mammography is no longer investigational, some insurers still consider 3D mammography to be experimental and don't automatically cover it. The Pennsylvania Insurance Department has received complaints from "many" consumers regarding charges for tomosynthesis.

Not anymore. Gov. Wolf's new policy mandates that insurance companies cover all mammograms with no co-pays for women, even those getting the most sophisticated screening.

"Well, it's the best news I've heard," said Dr. Copit.

In other states, including New Jersey and Delaware, insurance coverage varies for 3D mammograms.

For more information:

Pennsylvania Insurance Department announcement

http://www.media.pa.gov/Pages/Insurance-Details.aspx?newsid=141

Marion-Louise Saltzman Women's Center of Einstein Medical Center

http://www.einstein.edu/women/locations/saltzman-center/

 

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