Medicare Imaging Cuts Will Limit Patient Access to Care and Drive Qualified Physicians from Field
If not removed when the US House of Representatives reconsiders the Deficit Reduction Act of 2005 in the coming weeks, the drastic Medicare reimbursement cuts for out-of-hospital medical imaging procedures in the bill, passed by the US Senate today via a 51-50 vote, with Vice President Cheney casting the deciding vote, may force many physicians to stop offering much needed imaging services and limit the number of Medicare patients they receive. These drastic cuts may also force radiologists in rural areas to relocate to hospitals in larger metropolitan areas.
In a move totally contrary to the good-faith effort of radiologists and other physicians regarding the increased utilization of imaging services, Congress has decided to randomly and arbitrarily cap the technical component reimbursement for physician office imaging to the lesser of the Hospital Outpatient Prospective Payment or Medicare Fee Schedule payment. The legislation also calls for a 25% reimbursement cut for imaging exams on contiguous body parts in the same session in 2006 with an additional 25% reduction to take effect in 2007.
These cuts disproportionately affect radiologists, radiation oncologists, and other qualified physicians who have made a considerable investment in imaging equipment. Furthermore, this policy does not differentiate between diagnostic services and treatment planning services that are needed for cancer patients.
"This one-size-fits-all approach will have a disastrous effect on patient care, particularly in rural communities that do not have large hospitals convenient to them and rely predominantly on in-office imaging care. The ACR has worked closely with Congress and other governmental bodies to educate our elected officials on sensible alternatives that will help rein in costs and improve quality of care," said James P. Borgstede, MD, chair of the Board of Chancellors. "The Medicare Payment Advisory Commission (MedPAC) has agreed with many of these principles and recommended more focused measures to Congress. For our elected officials to ignore recommendations made by the experts in this area in favor of draconian cuts is extremely shortsighted and will do far more harm than good. I pledge that the ACR will work with all possible allies to mitigate this legislation. Even if not removed by the House, these policies will not go into effect until 2007. I promise that we will spend the next few weeks and, if necessary, the next year doing whatever is necessary to educate and lobby our lawmakers to change these ill-advised laws."
Text of Bill:http://www.rules.house.gov/109/text/s1932cr/109s1932_text.pdf
Vote Roll Call of Bill (in both House and Senate):
http://clerk.house.gov/evs/2005/roll670.xml
http://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=109&session=1&vote=00363