ACR Blasts ‘Significant and Unwarranted’ Medicare Imaging Fee Cuts

July 7, 2011

“Significant and unwarranted” medical imaging cuts in the Proposed Medicare Fee Schedule Rule for 2012, on top of “extreme” cuts to imaging services over the last five years, will drive many imaging providers from practice, restrict access to care, even for procedures not specifically affected by the cuts, and may actually increase Medicare costs for many of these services, the American College of Radiology said Tuesday.

“Significant and unwarranted” medical imaging cuts in the Proposed Medicare Fee Schedule Rule for 2012, on top of “extreme” cuts to imaging services over the last five years, will drive many imaging providers from practice, restrict access to care, even for procedures not specifically affected by the cuts, and may actually increase Medicare costs for many of these services, the American College of Radiology said Tuesday. The organization called for their removal from the final rule.

In its proposed rule for 2012, the Centers for Medicare and Medicaid Services called for a multiple procedure payment reduction (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 says.
The proposed rule also would further expand the number of physician services at risk for bundling of payment, the ACR says.

“These proposed cuts are not evidence-based and simply represent blind cost-cutting,” said John A. Patti, MD, FACR, chair of the American College of Radiology Board of Chancellors. “The time, intensity and mental effort it takes to interpret an individual exam is relatively constant regardless of whether the patients’ exams are interpreted separately or at the same session. Medicare should support such quality care and not repeatedly attempt to undermine it.”
This MPPR reduction and potential further bundling of payment contained in the MPFS Proposed Rule are premised on Medicare Payment Advisory Commission (MedPAC) recommendations rooted in the mistaken belief that mispricing of diagnostic imaging services has led to overutilization, the ACR argues.

A review of claims data by the Moran Company proves that medical imaging growth in Medicare is less than 2 percent per year - well in line with or below that of other major physician services. Growth in use of CT scans and other advanced imaging is roughly half of what it was even as little as three years ago.

The ACR points out that medical imaging providers have endured significant and continued reimbursement cuts in recent years, which have reduced payment rates for many critical diagnostic services by as much as 60 percent.

A bipartisan group of 61 Members of Congress, led by Rep. Pete Olson (R-TX) of the House Energy and Commerce Committee and Rep. Jason Altmire (D-PA) of the House Small Business Committee, signed and circulated a letter to congressional colleagues opposing the very imaging cuts recommended by MedPAC and now proposed by CMS.