PAD Task Force Commends Reintroduction of ARC Act in Congress

April 20, 2021—Members of the Peripheral Artery Disease (PAD) Task Force praised lawmakers for the introduction of the Amputation Reduction and Compassion (ARC) Act (H.R. 2631) in Congress. The legislation is intended to reduce unnecessary amputations resulting from PAD. The bill provides coverage of PAD screening for at-risk beneficiaries under the Medicare and Medicaid programs without the imposition of cost-sharing requirements. In 2020, the bill for ARC Act (H.R. 8615) was introduced but expired with the close of the Congressional session.

According to PAD Task Force, the ARC Act seeks to encourage appropriate screening and early detection of dangerous complications. It disallows payment for nonemergent amputations—unless anatomic testing has been done in the 3 months before an amputation. The legislation also provides resources for a PAD education program to support, develop, and implement educational initiatives that inform health care professionals and the public about PAD, as well as methods to reduce amputations, particularly with respect to at-risk populations including racial and ethnic minorities. The announcement coincides with National Minority Health Month in April.

The bill was introduced by Representative Donald Payne, Jr. (D-NJ) along with original cosponsors Representatives Jeff Van Drew (R-NJ), Bobby Rush (D-IL), Ruben Gallego (D-AZ), Mark Takano (D-CA), Raul Grijalva (D-AZ), Katie Porter (D-CA), Darren Soto (D-FL), G.K. Butterfield (D-NC), Ayanna Pressley (D-MA), and Albio Sires (D-NJ).

The announcement noted that minority populations in the United States are at disproportionately higher risk for amputations from PAD. The Task Force cited data compiled by the Dartmouth Atlas of Health Care demonstrating that Black Americans are over three times more likely than Whites to experience a nontraumatic amputation as a result of diabetes, a common PAD risk factor. Similarly, Native Americans are more than twice as likely to be subjected to amputation, while Hispanics are up to 75% more likely to have an amputation.

In 2019, Congressmen Donald Payne, Jr. (D-NJ) and Gus Bilirakis (R-FL) formed the Congressional PAD Caucus to educate Congress and communities about PAD in order to ensure increased PAD awareness, better access to PAD screening, and the prevention of nontraumatic amputations through the use of anatomic testing.

The PAD Task Force includes the Association of Black Cardiologists (ABC), the CardioVascular Coalition (CVC), CLI Global Society, Preventative Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions (SCAI), and Society of Interventional Radiology (SIR).

“The ARC Act is a historic intervention destined to alter the cardiovascular health outcomes of at-risk PAD patients and address the virulent practice of PAD-related amputations,” commented Foluso Fakorede, MD, in the announcement. Dr. Fakorede, who is Cochair of the ABC PAD Initiative, continued, “The ABC welcomes this bipartisan effort and implementation of policy action in hopes of achieving genuine health equity.”

Jeffrey Carr, MD, a member of the CVC and Cofounder of the Outpatient Endovascular and Interventional Society, added, “With the introduction of the ARC Act, and in recognition of National Minority Health Month, we have the opportunity to expand coverage for simple, noninvasive screening tests that will empower patients to take steps to manage their PAD before amputation becomes necessary.”

Lola Coke, PhD, a cardiovascular clinical nurse specialist with the Preventive Cardiovascular Nurses Association, stated, “The ARC Act constitutes an important step towards preventing unnecessary amputations related to PAD. By expanding coverage for screening tests and supporting public and provider education especially in high-risk patients like chronic smokers and diabetics, we have the opportunity to minimize the progression of the disease and save limbs for those diagnosed with PAD.”

Joaquin Cigarroa, MD, SCAI Government Relations Committee Chair, noted, “Approximately 20 million Americans have PAD and an estimated 200,000 of them—disproportionately from minority communities—suffer unnecessary amputations every year. The Society for Cardiovascular Angiography and Interventions supports this bill because we believe 200,000 is too many.”

Finally, SIR President Matthew S. Johnson, MD, stated, “Patients deserve to know and have access to all treatment options. With noninvasive screenings, the ARC Act will empower patients to make informed decisions about their PAD treatment. The earlier we are able to catch and treat PAD, the more likely we are able to avoid amputations and preserve patients’ quality of life.”