ACR Applauds Congress for Passing the Medicare Improvements for Patients and Providers Act
Physician Reimbursement and Quality Standards Preserve Seniors’ Access to Quality Imaging Care
The American College of Radiology (ACR) commends the U.S. Senate for, on July 9, overwhelmingly passing Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331). The bill repeals a statutorily mandated 10.6 percent physician payment cut, which became effective July 1, as well as an additional 5 percent cut set for Jan. 1, 2009, and instead provides a 0.5 percent payment increase for the rest of 2008 and a 1.1 percent update through 2009.
The legislation also calls for providers of advanced diagnostic imaging services (MR, CT, PET, and nuclear medicine) to be accredited in order to receive payment for the technical component of those services, and establishes a two-year voluntary demonstration program to test the use of physician-developed Appropriateness Criteria. The 69-30 Senate vote and recent 355-59 passage of the bill by the U.S. House of Representatives represent the necessary support to override a threatened veto of the bill by President Bush.
“The ACR is gratified that Congress has acted to preserve access to care for our nation’s seniors by averting this drastic reimbursement cut and at the same time increasing the quality of those services by enacting quality and safety standards for medical imaging providers,” said James H. Thrall, M.D., FACR, chair of the ACR Board of Chancellors. “Accreditation, as called for in this legislation, assesses the overall quality of a practice, including personnel, equipment, quality assurance (QA) activities, and ultimately the quality of patient care. The imaging provisions in this bill are a major step toward ensuring that beneficiaries receive consistent, quality care nationwide.”
The physician reimbursement cuts averted by this congressional action are required by the Medicare Sustainable Growth Rate (SGR) formula which dictates that once volume of services reaches a certain threshold, payment for each individual service is decreased to remain within a predetermined spending limit. Such reductions impose an arbitrary payment that does not factor in the cost to physicians of providing services.
“The double-digit cuts that this bill averted may have forced many physicians to limit the number of Medicare patients that they see because reimbursement could have fallen below the cost of providing the exams. The reimbursement updates called for in this legislation will help maintain the ability of physicians to provide high-quality care in the communities in which they serve,” said Thrall.
Putting Quality First
Previously, the only federal quality and safety standards for medical imaging regarded mammography and were called for by the Mammography Quality Standards Act. Despite the fact that mammography has been proven to decrease breast cancer mortality and that the MQSA standards have undoubtedly raised the quality of mammography being performed nationwide, these patient protections had not been extended to other imaging exams, until now.
“Quality standards for mammography facilities have been credited with saving tens of thousands of lives. Similar standards for other imaging exams, as called for in this legislation, are needed to help ensure that seniors have access to high quality, life-saving imaging care regardless of which part of the country they live in. I am glad that Congress has recognized and acted on this need,” said ACR Chair Thrall.
ACR accreditation would ensure that the physicians supervising and interpreting medical imaging meet stringent education and training standards, that the imaging equipment is surveyed regularly by qualified medical physicists to ensure that it is functioning properly, and that the technologists administering the tests are appropriately certified.
ACR Appropriateness Criteria® help physicians prescribe the most appropriate imaging exam for more than 200 clinical conditions (particularly when an imaging exam that does not use radiation may be more appropriate for a given condition). The College routinely reaches out to other medical specialties to make them aware of this guidance and encourages them to utilize this important tool.
“The imaging standards and the appropriateness criteria pilot program included in this bill will improve the quality of care that our nation’s seniors receive and the physician reimbursement updates will help protect the ability of physicians to continue to provide care. The ACR urges President Bush to sign this bill into law,” said Thrall.
To arrange an interview with Dr. Thrall, please contact ACR Public Relations Manager Shawn Farley at (703) 648-8936.