Issue Background

Protecting Access to Lifesaving Screening Act of 2021

It is critical the PALS Act of 2021 becomes enacted so women will have access to breast cancer screenings without the burden of costly deductibles or cost-sharing. 

The Protecting Access to Lifesaving Screening or “PALS” Act of 2021 would preserve payment for mammography screening before age 50. Senate Bill 2412, introduced by Sens. Dianne Feinstein (Calif.) and Marsha Blackburn (Tenn.), and House Resolution 4612, introduced by Reps. Debbie Wasserman Schultz (Fla.) and Fred Upton (Mich.), these bills would postpone recognition of controversial recommendations from the U.S. Preventive Services Task Force , that could limit access to breast cancer screening for women in their forties. USPSTF is an influential health care advisory group that often informs payment policy for Medicare and private insurers. The USPSTF recommendations are a departure from breast cancer screening guidelines of leading clinical organizations for women’s health — including the American College of Radiology, Society for Breast Imaging, National Comprehensive Cancer Network and the American Medical Association.

In 2009, USPSTF updated its guidelines and advised against annual mammograms for women in their 40s. Additionally, the task force recommended women in the 50-74 age range only need mammograms every two years. Moratoriums on delaying these guidelines were initiated in 2015, with the next moratorium expiring on Jan. 1, 2023.

The PALS Act of 2021 would extend the current congressional moratorium until Jan. 1, 2028, and preserve Medicare coverage for screening mammography, without a requirement for coinsurance, including digital procedures and extending to the Veteran’s Health Administration policy on screening veterans.

The PALS Act of 2021 seeks to:

  • Extend the PALS Act moratorium through Jan. 1, 2028.
  • Clarify that service women should benefit from this same screening mammography protection starting at age 40.
  • Adds clarifying statutory language that specifies “all modalities” is intended to include breast tomosynthesis; some insurers have failed to cover 3D mammography claiming the statutory language is unclear.