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Imaging Providers Plan Rally on Capitol Hill to Protect Reimbursements

Cheryl Clark, for HealthLeaders Media, October 13, 2009

The imaging community is getting increasingly nervous.

After rebounding from severe cuts several years ago enforced under the Deficit Reduction Act, the radiology community and others who bill for CT, MRI, X-ray, ultrasound, and related services face further cuts under a variety of health reform proposals.

But now they face a new threat. Last week, the Office of Inspector General unveiled plans to look into the payments and appropriateness of many scans performed in emergency rooms under Medicare Part B.

A blast on the American College of Radiology's Web site yesterday warned providers "to be prepared. Radiologists and their staffs should properly document the medical necessity of and correctly code for their services."

"The Medicare people are looking for money, and they've latched on to imaging as a place where they can mine more of that money," said Shawn Farley, ACR spokesman. "But we feel they're a bit short-sighted in their request."

Farley explained that federal officials are licking their chops when they see growth rate charts published by the Medicare Payment Advisory Committee this March. Those charts show dramatic annual increases for imaging services between 2002 and 2006 of 4.7% average per year. For example, advanced CT scans rose 11.1%, echography rose 10.1%, breast imaging increased 9.4%, and advanced MRI imaging tests increased 12.6%. And all those percentages are average annual increases for each of those years.

But after the Deficit Reduction Act imposed cuts several years ago, those percentage increases have dropped. Overall, imaging services grew only 2% between 2006 and 2007. Advanced CT rose 5.4%, standard breast exams rose 4.7%, advanced MRI increased only .8%, and echography was up by 7.3%, the MedPac report showed.

Farley says the real culprits in rising utilization of imaging services are not radiologists, but those in non-radiologist physicians who purchase relatively inexpensive scanning devices, such as X-ray or ultrasound machines, for their offices.

In an effort to tell Congress how they feel, 14 advocacy groups plan to rally on the Rayburn Building on Capitol Hill tomorrow to persuade Congress not to cut imaging payments, saying "drastic repercussions" would ensue.

Specifically, they say that it would force many practices that offer such services to go out of business, and the impact "would hit rural communities the hardest" forcing patients to drive even farther to get the imaging services they should have.

The American College of Radiology is not among the 14 groups. Those who plan to rally include the American Federation for Aging Research, the American Pain Foundation, the Brain Injury Association of America, and the Emergency Coalition to Save Cancer Imaging.

The groups plan to release a new analysis by the Moran Company showing a continued decline in growth of volume of advanced imaging services under Medicare for 2008.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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