Osteoporosis Screening

Bone mineral density testing (also known as bone mass measurement) can predict a woman’s risk for bone fractures, one of the most common and debilitating consequences of osteoporosis.¹ Medicare pays for bone density testing for five high-risk groups.² States can help most women not on Medicare gain access to this screening by requiring private insurers to cover bone density testing for high-risk people.

Impact of the Affordable Care Act

Health plans are required to cover, without copayments, the preventive services recommended by the United States Preventive Services Task Force (USPSTF), including osteoporosis screening for high-risk groups. This provision took effect in September 2010. Additionally, the list of free required preventive services will be updated in 2011 to ensure that services women in particular need are included."Grandfathered" plans--those that existed before the Affordable Care Act was passed--are exempt from this requirement, but plans will lose their grandfathered status if they significantly cut benefits, increase out-of-pocket spending, or change insurance carriers.

Does the state require private insurers to cover bone density screening for certain high-risk groups?

States receive a "meets policy" if they require private insurers to cover bone density screening. States with no mandated bone density screening coverage requirements receive a "no policy."

The source for this indicator has modified the way it reports data, necessitating a change in evaluation criteria. Consequently, there is no comparison to 2007. Requirements apply to MCOs and large group market (50+ employees) only.

State	Strength of Policy	Change from 2007
Alabama	No Policy	N/A
Alaska	No Policy	N/A
Arizona	No Policy	N/A
Arkansas	No Policy	N/A
California	Meets Policy	N/A
Colorado	No Policy	N/A
Connecticut	No Policy	N/A
Delaware	No Policy	N/A
District of Columbia	No Policy	N/A
Florida	Meets Policy	N/A
Georgia	Meets Policy	N/A
Hawaii	No Policy	N/A
Idaho	No Policy	N/A
Illinois	Meets Policy	N/A
Indiana	No Policy	N/A
Iowa	No Policy	N/A
Kansas	Meets Policy	N/A
Kentucky	Meets Policy	N/A
Louisiana	Meets Policy	N/A
Maine	No Policy	N/A
Maryland	Meets Policy	N/A
Massachusetts	No Policy	N/A
Michigan	No Policy	N/A
Minnesota	No Policy	N/A
Mississippi	No Policy	N/A
Missouri	Meets Policy	N/A
Montana	No Policy	N/A
Nebraska	No Policy	N/A
Nevada	No Policy	N/A
New Hampshire	No Policy	N/A
New Jersey	No Policy	N/A
New Mexico	No Policy	N/A
New York	Meets Policy	N/A
North Carolina	Meets Policy	N/A
North Dakota	No Policy	N/A
Ohio	No Policy	N/A
Oklahoma	Meets Policy	N/A
Oregon	No Policy	N/A
Pennsylvania	No Policy	N/A
Rhode Island	No Policy	N/A
South Carolina	No Policy	N/A
South Dakota	No Policy	N/A
Tennessee	Meets Policy	N/A
Texas	Meets Policy	N/A
Utah	No Policy	N/A
Vermont	No Policy	N/A
Virginia	No Policy	N/A
Washington	No Policy	N/A
West Virginia	No Policy	N/A
Wisconsin	No Policy	N/A
Wyoming	No Policy	N/A

Policy Indicator Counts

Meets Policy:

14

Limited Policy:

0

Weak Policy:

0

No/Harmful Policy:

37

Better:

0

Same:

0

Worse:

0

Data Source: The Henry J. Kaiser Family Foundation, "State Mandated Benefits: Osteoporosis Screening," 2008, on file with the National Women's Law Center.

Footnotes

¹ U.S. Department of Health and Human Services, Bone Health and Osteoporosis, A Report of the Surgeon General, Chapter 8: Assessing the Risk of Bone Disease and Fracture, 2004, available at http://www.surgeongeneral.gov/library/bonehealth/chapter_8.html, accessed September 24, 2010.

² Medicare covers bone density testing (using all FDA-approved technologies) for five categories of high-risk individuals: estrogen-deficient women at clinical risk of osteoporosis and who are considering treatment; individuals with vertebral abnormalities; individuals receiving long-term glucocorticoid (steroid) therapy; individuals with primary hyperparathyroidism; and individuals being monitored to assess the response to or the efficacy of approved osteoporosis drug therapies. 42 U.S.C. § 1395x (2009).