Medicare Coverage of Routine Screening for Thyroid Dysfunction (2003) / Chapter Skim
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1. Introduction
1. Introduction
Pages 7-13
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From page 7... ...
Section 123 of the Consolidated Appropriations Act for 2001 commissioned the National Academy of Sciences, now known as the National Academies, "and as appropriate in conjunction with the United States Preventive Services Task Force, to conduct a study on the addition of coverage of routine thyroid screening using a thyroid stimulating hormone test as a preventive benefit provided to Medicare beneficiaries under Title XVIII of the Social Security Act for some or all Medicare beneficiaries" and to "consider the short-term and long-term benefits, 7
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The remaining sections of this chapter summarize the evolution of the Medicare program and the processes that Medicare uses to determine what services it will cover. Subsequent chapters summarize the clinical concepts of thyroid disease, its diagnosis, and treatment; describe and execute an analytic framework for the assessment of TSH testing as a preventive measure; and discuss the specific effects of current Medicare coverage of TSH testing and implications of its expansion.
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The insurer does not obtain or provide services; it provides financial reimbursement to the patient after the fact. There is no need for direct contact between the insurer and the health care provider (e.g., doctor, hospital)
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This expectation has spread to the Medicare program, where about 80 percent of beneficiaries have supplemental coverage that helps pay for excluded services, deductibles, and copayments (IOM, 2000~. Today most insurance plans make direct payments to health care providers that usually constitute payment in full.
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The decision-making process involves consultation with a Medicare Coverage Advisory Committee and takes advantage of the growth of the clinical evaluative sciences by obtaining systematic reviews of scientific evidence provided by sources such as the Food and Drug Administration, the National Institutes of Health, and the Evidence Based Practice Centers supported by the Agency for Healthcare Research and Quality. The expansion of Medicare coverage to preventive services has been an exception to this established structure.
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In addition to the Committee's own knowledge and expertise, the Committee relied on three additional sources of information: (1) a systematic evidence review of the medical literature that was commissioned in conjunction with the United States Preventive Services Task Force; (2)
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2000. Extending Medicare Coverage for Preventive and Other Services.
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