ACR Education Efforts at CMS Result in Significant HOPPS Updates for Certain Radiology Procedures
The ACR submitted comments on Jan. 28, 2008, to the Centers for Medicare and Medicaid Services (CMS) regarding the Final Rule for the 2008 Hospital Outpatient Prospective Payment System (HOPPS).
Despite extensive comments by the ACR and other specialty societies, CMS has decided to move forward with extensive packaging of a large amount of radiology imaging services, diagnostic radiopharmaceuticals, and contrast into procedural codes, thereby allowing one consolidated payment for a service that commonly involves several ancillary services.
In general, the ACR opposes the packaging of any drugs or imaging into radiology and radiation oncology services and had requested a delay until potential impacts and methodology could be fully evaluated to insure that such efforts did not result in large negative impacts to hospital outpatient radiology departments.
However, the ACR expressed concern in its comments on the proposed rule for 2008 that outpatient radiology departments would experience a 25 percent reduction in interventional radiology payments as a result of how cost data was being handled under the new methodology and asked for a delay in implementation.
CMS is moving forward with the packaging but did modify its methodology as a result of the ACR’s comments, and now hospitals will receive as much as a 40 percent increase in interventional radiology payments. These efforts have also resulted in positive implications for other radiology services in the outpatient setting. The ACR continues to be concerned about CMS’ aggressive efforts at packaging, because the formula has not been fully disclosed and has very volatile effects. Therefore, the ACR will continue to work extensively on this issue as it develops to insure that radiology and radiation oncology data is being processed correctly in the new packaging methodology.
In our comment letter on the final HOPPS rule, the ACR provided a more detailed assessment of the implications of the packaging with specific comments on the ancillary services of concern to the ACR and its members.
The ACR presented positions on the following issues:
· The complex proposal by CMS to package payment for seven categories of supportive ancillary services. Of these seven categories, five are of critical importance to radiology: imaging guidance services, image processing services, imaging supervision and interpretation services, diagnostic radiopharmaceuticals and contrast media, and radiation oncology services.
· Composite ambulatory payment classifications (APCs)
· Placement of new technologies
· Charge compression
· The implications of the final rule with respect to the caps on imaging payments imposed by the Deficit Reduction Act.
The ACR also expressed support for CMS in their decisions to:
· Continue to pay separately for therapeutic radiopharmaceuticals
· Place cardiac computed tomography and coronary computed tomographic angiography in new APCs with an increase in payment
Click here to read the ACR comment letter to CMS.The ACR will continue to inform members of any CMS actions or decisions of note. The ACR volunteers and staff are working diligently on behalf of their members and will always keep you promptly informed of the positive results of our efforts.
