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Comments, Opinions, and Brief Case Reports
Health Care Reform
June 14, 2010

Diffusion of Computer-Aided Mammography After Mandated Medicare Coverage

Author Affiliations

Author Affiliations: Department of Family and Community Medicine, University of California, Davis Health System, Sacramento (Dr Fenton); Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis (Ms Foote); and Department of Family Medicine, University of Washington, Seattle (Drs Green and Baldwin).

Arch Intern Med. 2010;170(11):987-989. doi:10.1001/archinternmed.2010.104

When signed into law in 1965, Medicare was envisioned as a safety net to protect seniors from catastrophic financial loss following acute illness or hospitalization.1 At that time, medical care for older adults consisted predominately of illness care,2 and preventive care was not viewed as an essential component of the Medicare program. Indeed, the Medicare statute explicitly excluded coverage of preventive services.3 Although recent legislation (the Medicare Improvements for Patients and Providers Act [MIPPA] of 2008) empowered the Centers for Medicare and Medicaid Services (CMS) to add Medicare coverage for preventive services under specific conditions,4 addition of Medicare coverage for preventive services previously required Congressional action.3 This requirement made it possible for nonscientific interests to influence coverage policy.

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