Reduction In Radiology Rates Will Limit Access for Medicaid Patients
CT News Junkie | by Christine Stuart
Patients on the state’s Medicaid program may have to wait a little longer for a chest x-ray or a mammogram, if the General Assembly doesn’t restore cuts to radiology services.
Earlier this year, as part of a budget rescission, the state cut rates for radiology services and obstetrics and gynecology. The General Assembly on June 3 partially restored the funding for obstetrics and gynecology in the state budget, but they didn’t restore the 42.5 percent cut to radiology services.
Dr. Robert Russo, president of the Connecticut State Medical Society, said that means instead of seeing five Medicaid patients per day, these radiology centers will have to see one. That essentially creates an access issue for those who need these preventative services, Russo said.
“Why did you not restore us?” Russo, a radiologist, wondered.
The General Assembly’s budget adopted on June 3 annualized a cut in radiology rates for Medicaid patients by $4.45 million. It did restore a $500,000 cut to radiology rates for ultrasounds for high-risk pregnancies, but other radiology services will be reimbursed at 57.5 percent of the 2007 Medicare fee schedule.
Dr. Jean Weigert, director of women’s imaging at Mandell and Blau, said she sees the cut creating an issue with access to care.
“You can’t do a mammogram for $20,” Weigert said. “You can’t survive in an office performing $6 chest X-rays.”
She said she understands everyone had to tighten their belts, but it’s an issue of fairness. She said other specialties didn’t take as big a hit.
“I see this as a problem for access to care,” Weigert said.
It’s unclear why the General Assembly would restore obstetrics and gynecology and maintain the cut to radiology. Or even why radiology was on a chopping block in the first place.
Healthcare Advocate Victoria Veltri said she understands they are trying to cut down on the number of people seeing specialists when it’s not necessary, but it is vital to make sure the rates are adequate to guarantee patients who need those services receive them.
“It’s hard to make sense of this cut,” Veltri said Monday.
She said it seemed to be done with little regard for the impact it would have on the health of this population, which has grown under the Affordable Care Act.
She said instead of continuing to reduce reimbursement rates for services, the state needs to look maybe at increasing licensing fees.
“Medicaid and the providers of Medicaid have absorbed their fair share of cuts,” Veltri said. “We can’t afford to create access issues or we run the risk of undoing the good work that has been done to encourage people to use primary care. We will run the risk of higher-cost care when people cannot access providers.”
Ellen Andrews, executive director of the Connecticut Health Policy Project, said “It’s a very risky population and cutting things indiscriminately means you’re going to see the cost go up somewhere else.”
Since these are mostly preventative services, the cost for certain types of cancers may increase because they’re not detected in the early stages.
Russo said they will be asking lawmakers to take another look at the Medicaid rates when they convene for a special session later this month. He said there’s still time for them to correct this.
If they don’t, Russo predicted that community radiology centers will go under or try and get bought up by one of the large hospital networks in the state.
“They’re dropping out or getting bought up,” Russo said.
He said it makes no sense to spend all this time talking about improving the system of healthcare delivery if no one will be able to access it.
Rep. Peggy Sayers, D-Windsor Locks, said there’s been discussion about fixing it in a budget implementer, but there’s been no promises made. She said nothing will be finalized until after the House Democratic caucus on Tuesday.
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