A 17-member independent advisory group has urged Congress to get tough on doctors who order too many diagnostic imaging tests for Medicare patients. These tests include MRIs and CT scans, which the Medicare Payment Advisory Commission says are driving up the cost of health care for America's seniors. In its latest report to lawmakers, MedPAC said doctors who invest in their own imaging equipment and place it in their offices have "contributed to the rapid growth of imaging and other tests" and have "resulted in a high level utilization that likely includes unnecessary services." When a doctor orders an X-ray or MRI for a patient, and that test is given in the physician's office, the doctor keeps the profit from the charge for that test. Under the new recommendations, MedPAC would have the Centers for Medicare and Medicaid Services come up with guidelines for ordering these tests, and doctors who order too many of them would have to get prior approval. The proposal has set off a howl of protest from doctors and medical groups who argue it will delay much-needed medical care for Medicare patients and likely intrude on the doctor-patient relationship.
