Imaging Groups Laud SGR Fix Bill

February 7, 2014

Medical imaging industry groups hailed a bipartisan deal this week to replace the maligned sustainable growth rate formula for physician payment.

Medical imaging industry groups hailed a bipartisan deal this week to replace the maligned sustainable growth rate formula for physician payment.

Specifically, the American College of Radiology lauded the inclusion of ACR-backed provisions aimed at reducing unnecessary scanning and improving the quality of care.

The bill, which represents a bipartisan effort, would require ordering providers to consult appropriateness criteria when prescribing advanced medical imaging studies, the ACR noted. It would also direct the HHS secretary to find mechanisms for ordering physicians to consult the criteria, such as clinical decision support.

“The imaging appropriateness criteria provisions in this SGR bill will help ensure that patients get the right exam for the right condition and avoid care they may not need,” Paul Ellenbogen, MD, FACR, chair of the ACR Board of Chancellors, said in a statement. “This will raise quality of care and help preserve resources without interfering in the doctor-patient relationship or affecting access to care.”

The legislation would provide a 0.5 percent payment increase to physicians under Medicare each year through 2018, a provision ACR supported. The bill would also require that cuts greater than 20 percent be phased in over two years. The increase was welcome news for physicians who have seen repeated payment cuts in recent years, particularly to imaging services.

Another provision backed by the ACR would require CMS to show data used to justify a 2012 policy implementing a 25 percent multiple procedure payment reduction to certain imaging procedures provided to the same patient on the same day in the same session.

The Medical Imaging and Technology Alliance (MITA) also applauded the committee leadership for the deal.

“This bill’s requirement that ordering physicians consult physician-developed appropriate use criteria for advanced imaging services further encourages the safe and effective use of life-saving medical imaging, while ensuring patients have access to early detection and effective treatment,” Gail Rodriguez, executive director of MITA, said in a statement.

The bill still needs approval of both chambers and does not detail how Congress will pay for the full repeal.