While revised from 50% to 25%, multiple procedure payment reductions for imaging interpretation contained in the Medicare final rule released earlier this week by the Centers for Medicare and Medicaid Services (CMS) are "unfounded" and "potentially dangerous", the American College of Radiology (ACR) said today.
A statement issued by the society notes that the “unanticipated final rule expansion of this reduction to include multiple providers within the same group practice violates the spirit of the rule-making process.” It is also a signal that CMS lacks a fundamental understanding the practice of medicine, the ACR contends.
"This extension of the multiple procedure payment reduction to include physicians in the same group practice was not specifically included in the 2012 Medicare Fee Schedule Proposed Rule,” John A. Patti, chair of ACR’s Board of Chancellors, asserted in the statement. “No efficiencies in care support a funding cut when different physicians in a group practice interpret separate imaging scans for the same patient. There is no scientific support for this action. CMS should rescind it immediately.”
Moreover, the ACR contends, there exists no publicly available evidence to support a 25% reduction to physician interpretation payments in general. According to the statement, a recent study of professional component payment reductions for diagnostic examinations when more than one service is rendered by the same provider in the same session ( Journal of the American College of Radiology, September 2011) proves that any efficiencies in the multiple procedure setting are highly variable. Additionally,” they total at most one-fifth of what CMS contends.”
The statement emphasizes that multiple procedure reduction will affect the most vulnerable of Medicare beneficiaries: patients suffering from multiple trauma, stroke victims, and those with widespread cancer – all of whom often require multiple imaging scans to survive serious illness and injury, and the interpretation of which can often require the expertise of several different radiologists.
“Congress must act to protect seniors by passing the Diagnostic Imaging Services Protection Act (H.R. 3269),” the statement reads. “This act would block this multiple procedure payment reduction until and unless Medicare produces a study that would support such a cut in care.
"Medicare funding for imaging scans has been slashed $5 billion since 2007. The Obama administration recommended to the congressional supercommittee $1.3 billion more in imaging cuts. This may force many suburban and rural imaging providers to close, causing many seniors to travel farther and wait longer to receive care.”
The statement also includes a reference to a 2009 study conducted by the National Bureau of Economic Research, which demonstrated that increased use of imaging is directly tied to increased life expectancy.
“Those with less imaging access don’t live as long,” Bibb Allen, Jr., MD, chair of the ACR Commission on Economics, noted in the statement. “Continued cuts may cause more cancers and serious illnesses to go undetected until advanced stage, costing Medicare more money to treat and forcing patients to undergo more extensive treatment. These cuts may very well result in deaths that could be avoided through early diagnosis by imaging scans.”
The statement concludes with a reference to a recent national poll of 1,000 voters, nearly 90% of whom said they believe additional imaging cuts will affect early detection of medical conditions and diseases. A full 70% of Americans oppose further Medicare cuts to medical imaging, according to the ACR.