Congress delays reimbursement cuts

December 27, 2007

Among its final acts of 2007, Congress approved a moratorium delaying a scheduled 10.1% cut in Medicare physician reimbursement called for by the Sustainable Growth Rate formula. The cuts would have been implemented Jan. 1, 2008.

Among its final acts of 2007, Congress approved a moratorium delaying a scheduled 10.1% cut in Medicare physician reimbursement called for by the Sustainable Growth Rate formula. The cuts would have been implemented Jan. 1, 2008.

The House passed enabling legislation by a 411-3 vote. Adoption followed a unanimous consent vote in the Senate after talks for a more comprehensive healthcare plan were unsuccessful. Instead of a rate cut, physicians will receive an across-the-board 0.5% increase for the first six months of 2008.

The action ensures that Congress must address another Sustainable Growth Rate cut for the second half of 2008, according to American College of Radiology officials. Deliberations will probably again consider more cuts to the technical component of diagnostic imaging covered by Medicare, as Congress looks for ways to pay for delaying the across-the-board physician rate cuts, according to Josh Cooper, the ACR's senior director of government relations.

After failing to overcome two presidential vetoes, Congress also extended the Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP) at previous funding levels through March 2009. Bipartisan leadership in both houses had sought to expand the healthcare program for poor children.

Radiology was swept up in the controversy surrounding the renewal of SCHIP when a proposal to mandate facility accreditation for high-tech imaging and possibly billions of dollars in additional Medicare payment cuts for medical imaging appeared in House legislation to greatly expand the program. The House passed the Children's Health and Medicare Protection Act in August 2007, but it was deemed politically unworkable in the fall during House-Senate conference committee deliberations.

Several ACR-backed initiatives that congressional sources say would have likely been included in a more comprehensive House-Senate compromise bill will wait until 2008 for consideration. These include mandatory accreditation requirements for providers of MR, CT, PET, and nuclear medicine, a pilot Medicare program for imaging appropriateness criteria, changes in Medicare billing for the technical and professional components of diagnostic imaging, and an imaging referral disclosure requirement.

The ACR also announced plans in late December to continue to push for legislation that would set aside cuts contained in the Deficit Reduction Act of 2005 and implemented to chagrin of many freestanding imaging center operators in January 2007.

For more information from the Diagnostic Imaging archives:

Whacked! Radiology recoils under DRA ax

House approves imaging reforms in bill extending Medicare to poor children

CMS proposes 10% rate cut and self-referral restrictions in 2008 Medicare physician payment schedule