Statements on Introduced Bills and Joint Resolution

Floor Speech

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Ms. COLLINS. Mr. President, I rise today to reintroduce legislation with my colleague from Maryland, Senator Ben Cardin, to increase access to preventive bone density screenings and to improve osteoporosis diagnosis and treatment in the process.

May is National Osteoporosis month. Approximately 54 million Americans have osteoporosis or low bone mass. Women are disproportionally affected, accounting for 71 percent of osteoporotic fractures and 75 percent of health costs related to osteoporosis.

Osteoporosis is often called ``the silent disease'' because bone loss usually occurs gradually over the years without symptoms. As the NIH Osteoporosis and Related Bone Diseases National Resource Center observes, falls are especially dangerous for people who are unaware that they have low bone density. If the patient and the doctor fail to identify the link between the broken bone and osteoporosis, the chance to make a diagnosis with a bone density test and begin a treatment program may be lost.

Our legislation, the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021, tackles a proven barrier to proper screening by creating a floor reimbursement rate under Medicare for the dual energy X-ray absorptiometry (DXA) test, the ``gold standard'' for osteoporosis diagnosis.

Congress has twice recognized the importance of reversing Medicare cuts to DXA reimbursement in order to maintain patient access to this test, yet the Medicare reimbursement rate for DXA tests administered in a doctor's office has declined from $140 in 2006 to only $42 in 2018--a dramatic 70 percent decline. It is not surprising that this inadequate reimbursement has led to a decline in screenings.

The National Osteoporosis Foundation has found that declining reimbursement rates have created a 26 percent decline in physicians performing DXA tests since 2008, resulting in a corresponding 22 percent decline in diagnoses since 2009.

Regrettably, the result of reduced screenings due to declining reimbursements produces real harm. It is estimated that more than 40,000 additional hip fractures occur each year, resulting in nearly 10,000 additional hip fracture-related deaths. Keep in mind that these painful and costly fractures, and even deaths, are all occurring at a time when early diagnosis and treatment of osteoporosis are proven to reduce fracture rates dramatically.

With osteoporosis already an under-diagnosed condition in the Medicare population, it is clear that we must change this trajectory I thank Senator Cardin for joining me in this effort to increase patient access to osteoporosis screening and diagnosis, while lowering cost and consequences resulting from a lack of diagnosis. I encourage my colleagues to support its adoption. Thank you, Mr. President. ______

By Mr. REED (for himself and Mr. Tester):

S. 1944. A bill to improve Vet Centers of the Department of Veterans Affairs, and for other purposes; to the Committee on Veterans' Affairs.

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