insurers over mammography costs.

His attack comes amid plans for Dr. Brown to sit down with the Health Insurance Association of Bermuda to solve the row.

Last month Dr. Brown, medical director of Bermuda Health Care Services, rapped the HIAB over its new reimbursement rate of $75 for a mammogram. He said this was a 33 percent cut from the old rate of about $113.

But HIAB president Nicholas Warren said the $113 rate had only been for initial mammograms. Payments for subsequent or follow-up mammograms were calculated to be $65.20.

"An allowance was, therefore, made for the additional administration and time required on the first occasion.'' Mr. Warren said the HIAB executive decided a "composite'' rate of $75 should now apply to any mammogram.

Yesterday Dr. Brown said Mr. Warren was wrong to state there was additional administration for an initial mammogram.

"In fact there is more administration required on annual occasions because the technician and radiologist have to locate and compare old films.

"There is actually less administration time on the first one. Nowhere on the planet is this form of logic used.'' Dr. Brown said the HIAB appeared more interested in their "bottom line'' than reason.

He expressed hope, however for his meeting with the association.

"Mr. Warren has been a very reasonable man in the past, and I have no reason to expect him to be otherwise on this issue.'' This week the US Senate unanimously urged women to follow the guidance of organisations that recommend they begin having mammograms in their 40s.

Two weeks after scientific advisers wavered on when women should start having the X-ray exams for breast cancer, the Senate on Tuesday urged a National Cancer Institute advisory panel to consider reissuing an old guideline calling for mammograms of younger women.

The institute now recommends that women wait until 50 before having a mammogram.

An NCI advisory board two weeks ago was supposed to resolve conflicting advice about that issue. Instead, the board concluded only that, for women 40 to 49, "each woman should decide for herself.''