ACR Blasts Proposed Cuts, Sites Berwick's Comments

September 7, 2011

The ACR called on CMS to scrap proposed payment cuts in the Medicare Fee Schedule Rule for 2012, saying the reduction is “scientifically unfounded, based on flawed assumptions and may limit patients’ ability to receive efficient care.”

The ACR called on CMS to scrap proposed payment cuts in the Medicare Fee Schedule Rule for 2012, saying the reduction is “scientifically unfounded, based on flawed assumptions and may limit patients’ ability to receive efficient care.”

In a letter commenting on the proposed rule, the group also took issue with purported statements by CMS Administrator Donald Berwick, MD, during a recent Midwest tour of imaging facilities. His statements about imaging efficiencies, the ACR said, further challenge the validity of the proposed multiple procedure payment reductions (MPPR) of the professional component of imaging.

According to the ACR, during a visit to a St. Paul, Minn., facility, Berwick told radiologists that there “aren’t many efficiencies” when interpreting multiple studies. And during a visit to rural Wisconsin where radiologists expressed concern that the proposed cuts would limit access to efficient care, Berwick told the radiologists, “The efficiencies were more appropriate on the technical side rather than the professional side,” according to the ACR letter to CMS.

CMS has proposed an MPPR of 50 percent to the professional component of CT, MRI, and ultrasound services administered to the same patient, on the same day, in the same setting. This step, which the ACR called “unprecedented,” would slash the reimbursement for physician interpretation and diagnosis. Cuts have previously been applied only to the "technical component," or overhead costs of providing exams, the ACR said.

At the same time, several healthcare organizations, including the AMA, the Medical Imaging Technology Alliance, and the Medical Device Manufacturers Association, echoed ACR’s position. The groups recently sent comments to CMS saying the reduction was “redundant and unwarranted,” the ACR said.

In its letter, the AMA stated, “[CMS] oversimplifies related GAO and MedPAC recommendations, misconstrues the findings of the RUC, overlooks relevant CMS data and results in a proposal that is likely to increase costs to Medicare and its beneficiaries…”