Imaging advocates fire up opposition to healthcare reform

September 8, 2009

On the eve of a major presidential speech on healthcare reform, medical imaging advocates weighed in with political broadsides urging Congress to set aside legislative proposals they say will harm imaging device sales and clinical practices.

On the eve of a major presidential speech on healthcare reform, medical imaging advocates weighed in with political broadsides urging Congress to set aside legislative proposals they say will harm imaging device sales and clinical practices.

The Advanced Medical Technology Association (AdvaMed), which previously went on record favoring universal healthcare access, issued a news release Tuesday (Sept. 8) opposing $40 billion in proposed taxes on medical devices and diagnostics that it identified in a draft healthcare reform proposal from Sen. Max Baucus, chair of the Senate Finance Committee.

The association also announced its opposition to new fees proposed for medical laboratory services. In a separate release, the American Clinical Laboratory Association announced its opposition to $750 million in proposed taxes that the Senate Finance Committee bill would impose on clinical lab testing services.

"This tax will raise the cost of care for all patients, especially those in greatest need of advanced treatments and diagnostics," said Stephen J. Ubl, president of AdvaMed. "It is a form of double taxation, since a portion of hundreds of billions in cuts aimed at our customers, including hospitals, nursing homes, and home healthcare agencies will be passed on to us, Moreover, the tax will fall most heavily on the small and emerging companies that are the backbone of our industry."

The news release did not enumerate on how the so-called innovation tax would work, who would specifically be affected, or over what period of time it would apply. AdvaMed officials were not immediately available for comment.

As an alternative to the proposed fees, Ubl reiterated AdvaMed's support for comparative effectiveness research, value-based purchasing, preventive healthcare, and improved care coordination to improve healthcare systems' quality and efficiency.

NEW FEES FOR IMAGING MANUFACTURERS
An 18-page summary of the Senate Finance Committee's framework for comprehensive healthcare reform prepared by the law firm Reed Smith in Falls Church, VA, found few direct references to medical imaging. As also noted by the Access to Medical Imaging Coalition (AMIC), another lobbying group that represents medical imaging device manufacturing and professional practice interests, the proposed changes would raise the assumed utilization rate for advanced imaging equipment to 90%. The Department of Health and Human Services could exempt rural and other providers that expect to face a significant hardship from the higher rate, it said.

The framework for legislation proposes imposing a $4 billion annual fee specifically on medical device manufacturers, according to the summary. Pharmaceutical concerns would be hit with a $2.3 billion fee. Both taxes would be allocated by market share.In terms of insurance mandates, all plans sold to individuals and small groups through proposed state health insurance exchanges would be required to cover diagnostic imaging and x-ray screening services.

The legislation would support physician value-based purchasing. All eligible health professionals would be required to participate in Medicare's Physician Quality Reporting Initiative by 2011. The initiative establishes payment incentives for physicians for appropriate ordering of high-cost imaging services, expands the Medicare physician feedback program, and penalizes physicians who use significantly more resources than their peers.

VOTERS OPPOSE IMAGING CUTS
AMIC issued a public opinion survey Tuesday that it said showed 71% of voters oppose making further Medicare cuts to MRI, CT, and other advanced imaging tests and screenings.

An online survey of 4426 likely voters, conducted Sept. 4 to Sept. 8 by Zogby Interactive, found that 78% of respondents agreed that Congress's proposed cuts to medical imaging services, including MRI, CT, and PET scans, will have a significant impact on physicians' ability to detect disease and cancer at their earliest stages. Sixty-six percent of respondents agreed to a statement saying that President Obama should urge Congress to reject these additional medical imaging cuts during his Sept. 9 national address.

"Medicare cuts to diagnostic imaging are counterproductive to healthcare reform," said Tim Trysla, executive director of AMIC, in a release. "Early detection saves lives and money and eliminating physicians' ability to use advanced diagnostic imaging tools will just end up costing Medicare more money, and patients' health will suffer."

AMIC has joined the American College of Radiology in opposing proposed increases to the assumed utilization rate used to calculate outpatient Medicare reimbursement rates for advanced imaging. The current assumed rate is 50%. The House Tri-Committee bill would increase the assumed rate to 75%. The Senate Finance committee, as noted earlier, has proposed bumping the rate up to 90%.

AMIC contends that higher assumed rates to lead to lower Medicare reimbursements that would force imaging centers, particularly those based in rural areas, to scale back their services or go out of business.