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Vidyya, from the Sanskrit "vaidya," a practitioner who has come to understand the science of life.

Volume 2 Published - 14:00 UTC    08:00 EST    04-March-2001      
Issue 63 Next Update - 14:00 UTC 08:00 EST    05-March-2001      

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Back To Vidyya Patients & Physicians Testify:

Medicare Reforms Needed To Ensure Access To Lifesaving Medical Technology

Patients and their physicians told Congress on Friday that reforms must be made to the way the Health Care Financing Administration (HCFA) makes Medicare coverage and payment decisions to ensure that elderly and disabled Americans have timely access to the latest advances in medical technology.

The joint hearing of the House Commerce Subcommittee on Health and Subcommittee on Oversight & Investigations entitled "Patients First: A 21st Century Promise to Ensure Quality and Affordable Health Coverage," focused specifically on improving patients' access to new technologies in the Medicare program.

Kathleen Dziuba, a breast cancer survivor from Ann Arbor, MI, who testified at the hearing, said she would "ask that Medicare provide reimbursement for advances" in medical imaging like positron emission tomography (PET). She avoided an invasive and expensive biopsy surgery after PET confirmed that an abnormality on her lung was non-cancerous.

Dr. Paul Shreve, a diagnostic radiologist at The University of Michigan Health System, called on Congress to help eliminate Medicare delays that have kept many cancer patients from receiving needed PET scans for the past 10 years.

"PET is an example of a major advance in medical technology, an outgrowth of federally supported medical research, that has been kept from our patients far too long due to disorganized and indifferent federal agencies such as HCFA," Shreve said.

Over the last decade PET has become an indispensable tool in detecting many deadly diseases including multiple forms of cancer and Alzheimer's disease. However, it remains unavailable to Medicare patients for many key diseases because of delays and inefficiencies in Medicare's coverage process.

One of America's leading cardiologists, Jeffrey Popma, MD, from Brigham and Women's Hospital in Boston, said that Medicare patients have faced similar barriers in gaining access to a breakthrough treatment for blocked coronary arteries -- intravascular radiation. "The time lag has been entirely too long" between FDA approval and availability under Medicare. "Patients are in fact being denied care."

Coronary radiation therapy is performed by temporarily inserting radiation-emitting seeds into an artery through a minimally invasive catheter. The radiation affects the blood vessel's cells in a way that helps prevent reclosure of the artery after angioplasty. By reducing the incidence of artery reclosure (restenosis) after balloon angioplasty, patients are able to live healthier lives and avoid serious and expensive complications that often require follow-up surgery.

However, problems with Medicare reimbursement threaten to create a major access barrier for the 50,000 beneficiaries each year who could benefit from this treatment. Due to delays in Medicare procedures, hospitals are significantly under-reimbursed for intravascular radiation. HCFA will take at least two years to set an appropriate reimbursement level.

According to the Bush Administration's budget blueprint released this week: "Medicare is not adapted to 21st Century medicine. Medicare is often too slow to incorporate technologies and methods of delivering care ... As in virtually all fields, technological and entrepreneurial innovation are among the keys to creating more value for the dollar in health care."

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Editor: Susan K. Boyer, RN
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