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Medicare Cuts Back on Nutritional Screening

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One lab test per year to screen for all nutrient deficiencies or imbalances. Test your vitamin D levels, and you’re done. If you’re on Medicare and live in the Southwest, one test per year is all you’re allowed.

As part of the 2003 Bush Medicare bill, Medicare chose fifteen regional firms as Medicare Administrative Contractors (MACs). These MACS handle claims, deny or approve procedures, and make rulings on what is allowed to be covered under Medicare in their region.
Last month, Trailblazer Health Enterprises, the MAC for Region IV (Colorado, New Mexico, Oklahoma, and Texas), said that from now on, each beneficiary could receive only one lab test per year to detect deficiencies of vitamins, minerals, and other nutritional components. “Medicare considers vitamin assay panels [to be] a screening procedure and therefore, non-covered,” according to the decision. “Similarly, assays for micronutrient testing for nutritional deficiencies that include multiple tests for vitamins, minerals, antioxidants and various metabolic functions are never necessary.” This would be the most restrictive policy in the nation regarding tests for vitamins and minerals.
ANH-USA believes it’s critical to get complete nutritional profiles—or at least multiple nutrient tests—to ensure optimal health. This new policy discounts the importance of optimal nutrition and nutrient levels in the prevention and treatment of disease.
A spokesperson for a testing laboratory in Texas, who asked that the company’s name not be published, told us, “It is well known that physicians often find it reasonable and necessary to order multiple tests to detect deficiencies of vitamins, minerals and antioxidants (and such a position is fully supported by the scientific literature).
“On a routine basis, for example, physicians commonly order tests for vitamins B-12 and folate simultaneously. [Physicians who understand] the clinical relationships between nutritional deficiencies and disease processes may frequently find it reasonable and necessary to order a broader range of nutritional tests….Each of these physician’s orders—based on the physician’s determination of medical necessity—would be denied coverage under the proposed Trailblazer policy solely because more than one test is requested.”

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