Imaging cuts in proposed Medicare rule potentially dangerous, radiologists say

July 25, 2012

Extreme cuts to funding for medical imaging scans in the Medicare fee schedule proposed rule for 2013 are unnecessary, unfounded, and undermine care for the most sick or injure seniors, according to the American College of Radiology.

Extreme cuts to funding for medical imaging scans in the Medicare fee schedule proposed rule for 2013 are unnecessary, unfounded, and undermine care for the most sick or injured seniors, according to the American College of Radiology.

In particular, radiologists are concerned that the Centers for Medicare and Medicaid Services will reinstate its policy to apply the multiple procedural payment reduction of 25% to the professional component for computed tomography, magnetic resonance, and ultrasound services provided by one or more physicians in the same group practice furnishing services to the same patient, in the same session, on the same day.

“These cuts affect primarily those suffering from multiple trauma or heart attacks, stroke patients, and those with widespread cancer, all of whom often require multiple imaging scans to survive,” said Paul Ellenbogen, MD, chair of the American College of Radiology Board of Chancellors. “Interpretation of these scans often requires expertise of different physicians. These cuts discourage doctors from working as a team and pull the rug out from under the very physicians working to save these people’s lives.”

CMS expanded not only the number of physicians affected by this policy, but the number of exams, based on a theory that has been medically debunked, the college said in a statement. There is no publicly available evidence to support a 25% reduction to physician interpretation payments in general. A 2011 study proves that any efficiencies in the multiple procedure setting are highly variable and, at most, total one-fifth of what CMS contends. No efficiencies in care support a funding cut when different physicians in a group practice interpret separate imaging scans for the same patient, the statement said.

“These cuts are an expansion of a bad policy that lawmakers have already lined up against. More than 250 members of the House are already co-sponsors of the Diagnostic Imaging Services Access Protection Act (H.R. 3269), which would block the original multiple procedure payment reduction on which these are based. Medicare funding for imaging scans has already been slashed $5 billion since 2007. We call on lawmakers to protect care for the most vulnerable of our nation’s seniors by updating the bill to address these cuts and passing H.R. 3269 with all haste,” Dr. Ellenbogen said.

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