MPPR Correction Resurfaces, but What About the Utilization Rate?

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Radiology advocates are still reeling from the fiscal cliff deal, a piece of legislation that failed to reverse the multiple payment procedure reduction (MPPR) and boosted the utilization rate on imaging equipment to 90%. MPPR correction legislation is back on the docket and racking up co-sponsors, but what about the utilization rate? Rest assured, says Cynthia Moran, assistant executive director of government relations for the American College of Radiology (ACR), that reducing the utilization rate is still firmly on the agenda. ACR advocates prevented utilization assumption rate increases for many years, and Moran says it was only the “truncated, insular, behind-the-scenes legislative process...that enabled Congress to enact this flawed change.” ACR officials sent a letter (Jan 10, 2013) to the chairman and ranking member of the Senate Finance Committee vociferously opposing inclusion of the equipment utilization assumption rate within the fiscal cliff legislation. In addition, a key focus of ACR’s inaugural Stand Up for Radiology fly-in, conducted last month, focused on the utilization rate’s negative impact on radiology practices throughout the United States. cindy_moranDespite these efforts, optimism is in short supply at the ACR’s Reston, Va-based headquarters. “The current, challenging fiscal climate, combined with reforms to Medicare still being a major goal of federal policymakers, has ACR very pessimistic about the prospects of changes to the equipment utilization assumption rate being overturned,” says Moran. “Federal policymakers will hide behind the flawed MedPAC recommendations, and the President’s budgets for FY 2012 and 2013, as reasons for why this policy change is essential.”   ACR will continue to work with lawmakers, urging them to take a second look at utilization management policies. The overall message will include the fact that imaging reimbursement has been cut 12 times over the past 7 years, either through legislation or regulation. “The cumulative impact of these cuts cannot be ignored,” adds Moran. “Policymakers should instead focus on incentivizing the use of appropriateness criteria.”