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Susan G. Komen® Applauds Introduction Of Senate Diagnostic Legislation

Urges Quick Passage So Women Can Receive Affordable Diagnostic Exams

Susan G. Komen®, the world’s leading breast cancer organization, today applauded Sens. Roy Blunt (R-MO) and Jeanne Shaheen (D-NH) for introducing the Access to Breast Cancer Diagnosis (ABCD) Act. The legislation would eliminate out-of-pocket costs for medically-necessary diagnostic imaging.

“This is a significant step forward in addressing a barrier to care – cost – for women who need diagnostic imaging after an abnormality has been detected on her mammogram,” said Molly Guthrie, director of public policy and advocacy at Susan G. Komen. “We hear heartbreaking stories from women every day who cannot afford the significant out-of-pocket costs for follow-up imaging tests. This often leads to delays in lifesaving care. This legislation gets us closer to ensuring women can access the tests they require and receive timely treatment.”

Under current law, insurers are only required to cover 100 percent of the cost of screening mammograms, pushing no costs onto patients. But if that mammogram reveals an abnormality, patients then must pay out-of-pocket for any additional medically-necessary diagnostic imaging. Those tests can involve an ultrasound, breast MRI or diagnostic mammogram to determine if a biopsy is required.

A recent Komen-commissioned study found the costs to patients for diagnostic tests range from $234 for a diagnostic mammogram to $1,021 for a breast MRI. It is estimated that as many as 10 percent of patients who receive annual screening mammograms get called back for diagnostic imaging. Out-of-pocket costs are particularly burdensome to those who have previously been diagnosed with breast cancer, as diagnostic tests are often recommended rather than traditional screening mammography.

“Early breast cancer detection saves lives,” said Blunt. “Screening is vital, but getting the diagnosis confirmed so patients can start treatment as soon as possible is just as important. By ensuring full coverage of cancer diagnostic tests, this bill eliminates a major hurdle to care, leading to lower treatment costs and better outcomes.”

Added Shaheen, “No one should ever feel pressured to forgo a necessary cancer screening because they can’t afford it. This bipartisan legislation would require breast cancer diagnostic tests to be covered by health insurance in the same way that preventative screenings are covered, helping to ensure that these lifesaving tests are not out of reach for those who need them. Lowering health care costs and increasing access to critical services must be top priorities in Congress, and this bill helps make important progress on that effort.”