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Lobbyists battle for a piece of Medicare’s preventive coverage posted 7-28-97 While Congressional leaders and the Clinton administration are wrangling over whether to raise Medicare premiums for affluent beneficiaries and whether to increase the eligibility age from 65 to 67, another less public Medicare battle is taking place. Lobbyists for physician groups and for medical manufacturers are scrambling to get a piece of the business that will be generated when lawmakers expand Medicare’s coverage of preventive services, a move they have already agreed on. Congress is expected to increase Medicare spending, possibly as much as $4.6 billion over the next five years, for tests to detect some forms of cancer and other diseases. The implications of Congress’ decisions on testing could extend beyond Medicare to private health insurance plans. For example, if a medical test were written into law for use in the Medicare program, managed care plans possibly could require members to use the test even if critics claimed it was not the most effective one. One of the bitterest debates on Capitol Hill has been over how to detect colorectal cancer, the second deadliest form of cancer after lung cancer. Gastroenterologists are promoting the use of colonoscopes and sigmoidoscopes; radiologists are lobbying for barium X-rays. Under the Senate’s version of expanding prevention services, the Department of Health and Human Services makes the decision about which tests to cover. The House proposal names the specific tests it wants Medicare to cover. Reed Franklin, assistant director of federal government relations at the American Nurses Association, urges caution about naming specific tests in legislation because of rapid advancements in technology. "When specific tests are put in law, it literally takes an act of Congress to change," he said.
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