ACR lobbies Congress to freeze budget cuts for two years

June 1, 2006

Rather than fight to repeal the Deficit Reduction Act of 2005, the American College of Radiology has chosen instead to support a two-year delay in its implementation.

Rather than fight to repeal the Deficit Reduction Act of 2005, the American College of Radiology has chosen instead to support a two-year delay in its implementation.

The moratorium has support on Capitol Hill, according to Cindy Moran, ACR assistant executive director for government affairs and economic policy. She expects the House and Senate to introduce legislation in early to mid-June calling for a two-year freeze.

The legislation would also require the Government Accounting Office to study the potential implications of the DRA on imaging access, particularly in rural areas and regarding mammography. It would also call for the GAO to study whether the Hospital Outpatient Prospective Payment System (HOPPS) is the appropriate vehicle to reimburse physicians.

The proposal would need to find a home on a larger bill, possibly healthcare related, that has enough support to pass.

"We will be looking for anything in Congress that we feel can go the distance," Moran said.

The DRA, slated to go into effect on Jan. 1, 2007, slashes imaging reimbursement that the Congressional Budget Office estimates will save Medicare $2.8 billion over five years. The ACR's own audit suggests the cuts will actually hurt imagers to the tune of $6 billion over five years.

The savings to Medicare come by way of capping the technical component reimbursement for physician office imaging to the lesser amount of either the HOPPS or the Medicare Fee Schedule.

The moratorium will give the ACR and its coalition partners - GE, Philips, Siemens, and U.S. Oncology - a chance to educate lawmakers about the unintended consequences of the imaging cuts.

"The delay is a step - hopefully - toward repeal," said Josh Cooper, ACR senior director of government relations. "We need this delay because I don't think Congress has the will to repeal $2.8 billion."

Radiologists who are hospital based will suffer minimal impact. The ACR estimates, however, that nearly half of hospital-based radiologists also have some form of office-based or imaging center practice.

Radiologists whose sole means of income derive from an imaging center practice will be hit hardest. Feedback from ACR members indicates that MRI reimbursement could be reduced by 35%, while CT could be cut by 20%. The damage could increase depending on Medicare patient mix.

If the DRA goes into effect, Medicare will be the only payer that separates the technical component from the professional component. The ACR fears that in time other insurers will mimic this payment structure.

Another concern is that radiology will become a piñata for Congress. Because the current cuts to imaging were made in the wee hours of the morning without any hearings or vetting of policy, the ACR contends that Congress could easily do it again whenever it needs to come up with Medicare savings.

"If we fight this fight now, we can ensure that Congress will think twice before it cuts imaging payments," Moran said.

For more information from the Diagnostic Imaging archives:

Budget bill targets diagnostic imaging services

Congressional budget cuts hit radiologists