Efforts to delay DRA cuts may depend on political maneuvering

Industry lobbying to stop the Medicare cuts imposed by the Deficit Reduction Act of 2005 has gone about as far as it can for now. Legislation introduced in the Senate and the House of Representatives, if approved, would delay DRA implementation until 2009. Turning the new bills into laws, however, may take some 11th-hour maneuvering.

Although Congress may yet act next month, many members are intent on hitting the campaign trail and don't want to get bogged down in issues that could delay them. As a result, the discussion of the two bills might have to wait until a post-election conference in the waning weeks of the year.

"We have some critical meetings over the August recess that should give us a better understanding of what the leadership is thinking," said Tim Trysla, executive director of the Access to Medical Imaging Coalition, which spearheads the anti-DRA lobbying effort.

The solution may not be a single bill addressing this particular problem. In the past, as time ran out on important issues, Congress lumped bills together in an omnibus reconciliation act. That could happen again.

"If history teaches us anything, it may look exactly like that," Trysla said.

Momentum for action this year is building, however. Arguments by AMIC and the National Electrical Manufacturers Association have won bipartisan support in both houses.

"A lot of members of Congress, both Democrats and Republicans, are very concerned about patient access," said Ron Geigle, a spokesman for NEMA.

The bills now pending are aimed at delaying the DRA beyond its Jan. 1 implementation date. Imaging industry lobbyists see the potentially damaging effect the DRA could have on vendors and providers alike, but they have focused legislators' attention instead on how the DRA might affect patients. In hearings last month, legislators posed such questions to representatives of both the Centers for Medicare and Medicaid and the Medicare Payment Advisory Commission.

"And they said, 'We haven't done any analysis,'" Geigle said.

AMIC and NEMA have won support in Congress by noting the danger inherent in this uncertainty, while pointing out the unfairness of the DRA. According to Trysla, about one-third of the total Medicare savings accrue through cuts in imaging, even though imaging accounts for only about one-tenth of Medicare spending.