SCAI strongly supports the Amputation Reduction and Compassion (ARC) Act (H.R. 2631), introduced by Reps. Donald Payne, Jr. (D-N.J.), Bobby Rush (D-Ill.) and Ruben Gallego (D-Ariz.). The ARC Act seeks to reduce the number of avoidable amputations suffered by peripheral artery disease (PAD) patients. We, as clinicians, believe this legislation is an important step in working towards efforts to prevent unnecessary amputations in the United States, an issue that disproportionately impacts communities of color.
PAD is caused by atherosclerosis, or the build-up of plaque inside the arteries of a patient's lower extremities, and is a chronic, life-threatening condition. PAD is a risk for more than 30 million Americans living with diabetes and 84.1 million living with prediabetes. If left untreated, PAD can lead to critical limb ischemia (CLI) and amputation. Today, nearly 20 million Americans have PAD, and an estimated 200,000 of them—disproportionately from minority communities—suffer unnecessary amputations every year. Nationally, the amputation rate among Black Medicare beneficiaries is nearly three times higher than the rate among other beneficiaries. With increased access to early detection and preventative testing, as many as 85 percent of avoidable amputations could be prevented.
The ARC Act would reduce amputations by requiring Medicare, Medicaid, and group health insurance plans to cover preventative screenings for high-risk individuals so that PAD can be caught and treated early before it leads to amputation. Additionally, this bill would disallow payments for non-traumatic amputations if anatomical testing is not performed first. It also would establish a PAD education program at HHS, so that doctors are more aware of PAD symptoms and requires HHS to implement quality payment measures that will reduce avoidable amputations.