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March
10,
2009 -- 6:15pm EDT
Bent Out of SHAPE
Today the Texas House of Representatives has
been holding a public hearing on bill HB 1290, sponsored by Rep.
Rene Oliveira,
which mandates that any health insurance plan that
covers medical screening must also cover Coronary Artery Calcium
(CAC) screening, a test which currently is NOT covered by Medicare
or by
most insurance.
This
would be a major step forward for this imaging technology.
 Two
years ago, the Houston-based Society
for Heart Attack Prevention
and Eradication (SHAPE) group
issued a set of guidelines for early
detection of heart disease. As
reported on Angioplasty.Org, the SHAPE recommendations
generated quite a bit of controversy at the time, with passionate
advocacy of the test on the part of the SHAPE authors, and comments
from others in the cardiology community, such as Dr. Philip Greenland
of Northwestern, who called the report "an apparent effort to
subvert the long-standing evidence-based guidelines approaches" of
the major heart societies, such as the ACC and AHA. A
Texas bill, virtually the same as the current one, was voted down
in committee.
Which is why, to everyone's surprise, Dr.
Morteza Naghavi, founder of SHAPE and Chairman of the SHAPE Task
Force, stated in a Friday press release that, "We
are also pleased to know that the American Heart Association has
elected to support
the bill as well."
Well, not exactly.
As Larry Husten, former editor of theheart.org,
reported
last night in his blog CardioBrief,
the AHA has denied any
endorsement. He writes that the AHA spokesperson said:
...he had told the Texas legislators that “I
don’t know if we are there yet” and that without better scientific
evidence the AHA would be unable “to put a card in favor” of
the legislation.
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I contacted Dr. Naghavi of SHAPE. He told me that
he'd been informed of the AHA endorsement during a conference call
last Thursday by Michael Gray of Rep. Olivera’s staff.
Reportedly Joel Romo of the AHA had conveyed news of the AHA's support
to Mr. Gray and was "upbeat about it."
This afternoon the SHAPE Society sent me the following
statement:
"After the public announcement of the
March 10 hearing of the Texas Heart Attack Prevention Screening
Bill, our SHAPE representative was informed by Michael Gray,
from Congressman Oliveira's office, that the verbal commitment
he had received from AHA representative, Joel Romo, to support
the bill is no longer on the table. We are extremely disappointed
that, only hours prior to the hearing, AHA has backed out from
supporting such monumental bill, and, instead, wished to remain "neutral".
However, SHAPE remains hopeful that as new studies uncover
in the field, AHA will reconsider its position."
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Obviously, there's just a bit of politics going on here,
most of it outside the House of Representatives. What's
interesting is that among the many distinguished members of the SHAPE
Task Force
are Dr. Pamela
Douglas, a past-president of the American College of Cardiology and
Dr. Valentin Fuster, a past-president of the American Heart Association.
Angioplasty.Org
will be posting an in-depth report on the SHAPE recommendations
and their implications in today's healthcare environment. Stay tuned.
Late Update: SHAPE has revised its press
release and
removed the reference to the AHA endorsement, but you can still
read the cached
version here.
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