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Congressmen Send Letter to CMS Opposing Payment Reduction in 2012 Medicare Proposed Rule

From the American College of Radiology

Washington, DC (Aug. 5, 2011) – Rep. Pete Olson (R-TX) of the House Energy and Commerce Committee and Rep. Jason Altmire (D-PA) of the House Small Business Committee, recently sent a letter to Centers for Medicare and Medicaid Services Administrator Donald Berwick, MD, in opposition to a significant medical imaging cut in the Proposed Medicare Physician Fee Schedule Rule for 2012.

The proposed rule called for a multiple procedure payment reduction (MPPR) to the “professional component” of successive diagnostic imaging services administered to the same patient, on the same day, in the same setting. This unprecedented step would slash the reimbursement for physician interpretation and diagnosis. Cuts have typically been applied to the "technical component," or overhead costs of providing exams.

The Congressmen stated, “Since radiologists spend an equal amount of time, effort, and skill interpreting each diagnostic image, irrespective of modality, section of the body under examination, or date of service, we are concerned that these proposed cuts undervalue the role of the radiologist within the health care delivery system.”

Medicare imaging cuts are rooted in the mistaken belief that mispricing of diagnostic imaging services has led to overutilization. A review of Medicare claims data by the Moran Company proves that medical imaging growth in Medicare is less than 2 percent per year — well in line with or below that of other major physician services. Growth in use of CT scans and other advanced imaging is roughly half of what it was even as little as three years ago.

Since these cuts may drive many providers from practice in their communities or force them to cut back on services, the representatives warned Dr. Berwick that, “patients that receive multiple scans during a single session are typically affected by severe trauma, stroke, or widespread cancer. As a result, we are deeply concerned that the application of an MPPR to the professional component of multiple diagnostic imaging services will have the greatest impact on patients requiring serious medical treatment.”

Reps. Olson and Altmire recently sent a letter to the Chairmen of the House Committees on Energy and Commerce and Ways and Means opposing inclusion of medical imaging cuts in any legislation to move through Congress.  The letter to CMS Administrator Berwick references this Congressional sign-on letter, as well as the 61 bipartisan cosigners.

The ACR continues to educate CMS, Members of Congress, and other stakeholders about the adverse effect of CMS imposing an MPPR policy on the professional component of select advanced diagnostic imaging services. 


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