Proposed Rule Would Limit Multi-Procedure Payment Reductions

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A rule that strikes back against imaging cuts advocated by the Centers for Medicare and Medicaid Services (CMS) was introduced last week in the U.S. House of Representatives by Reps. Pete Olson (R-TX) and Betty McCollum (D-MN).

Co-sponsored by 31 House members, the proposed rule — known as the Diagnostic Imaging Services Protection Act (Bipartisan H.R. 3269) — would take effect next year and would prohibit any multiple procedure payment reduction to the “professional component” of CT, MRI, and ultrasound exams received by the same patient, on the same day, in the same setting. It is a response to a July 19 proposal by CMS to slash the reimbursement rate for multiple radiological assessments of diagnostic images by 50%.

"This substantial cut is a disservice to radiologists and ignores the fact that radiologists spend an equal amount of time, effort, and skill interpreting each diagnostic image, regardless of the number of images being examined, the section of the body being examined or the particular date of the imaging service," Olson and McCollum said in a joint statement. "Our legislation ensures that CMS does not arbitrarily undervalue the role of the radiologist within the healthcare delivery system."

The American College of Radiology (ACR) has come out in support of the legislation. John A. Patti, MD, chair of the ACR’s Board of Chancellors, noted in a statement the society's belief that multiple procedure reduction and other imaging cuts are unnecessary and ill-advised. He cited a study published in the September, 2011 issue of the Journal of the American College of Radilogy, which, he said, demonstrates that any efficiencies in physician interpretation and diagnosis when the same patient is provided multiple services in the same day are variable and, at most, “one-tenth of what policy makers contend.”

Patti added that Medicare funding for imaging has been slashed by $5 billion, in seven increments over the past six years. Medicare spending on imaging is at 2004 levels, and imaging growth is less than 2% annually. Accordingly, he contends that any further cuts would “damage access to care for those who need it most.”

“More imaging cuts lead directly to less access to modern care when Americans need it,” he concluded. "If our elected officials don’t protect access to imaging, no one — patients, providers, or politicians — will be happy with the long-term effects.”

Download a PDF OF the proposed bill.