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Manufacturers and users of low-field MRI scanners will probablydodge a bullet this month that could have been fatal for low-fieldreimbursement in California's workers' compensation system. Membersof a medical council participating in reform of the system
Manufacturers and users of low-field MRI scanners will probablydodge a bullet this month that could have been fatal for low-fieldreimbursement in California's workers' compensation system. Membersof a medical council participating in reform of the system areon the verge of abandoning a proposal to deny reimbursement forscans done on low-field systems.
The proposal to refuse low-field coverage was proffered asa means of reducing workers' comp costs. The system paid an estimated$266 million to radiologists last year (SCAN 10/21/92). MRI scansconstitute one of the fastest growing cost segments within radiology.
Low-field MRI has been singled out for attention because insurancecompanies participating in the system claimed that a disproportionatenumber of low-field scans must be repeated due to poor image quality.
Last year, members of the Industrial Medical Council (IMC),a group of physicians formed to make recommendations on workers'comp coverage, floated a trial balloon proposing that the systemno longer reimburse for low-field MRI scans.
Fortunately for low-field vendors and users, however, thatproposal has been withdrawn. Instead, the IMC will probably recommendthat the workers' comp system deny reimbursement for scans thatare not of acceptable quality. The interpreting radiologist willdetermine whether or not scans are acceptable, according to Dr.Michael M. Bronshvag, the IMC member who is conducting the reviewof low-field MRI reimbursement.
"The responsibility of the IMC is to worry about the patient,not the magnet," Bronshvag told SCAN. "We will probablycome out with different guidelines based on quality assurancefor the patient and let the radiologists and everybody else worryabout the magnet."
Bronshvag will make his recommendation on MRI coverage to afull meeting of the IMC in Los Angeles Feb. 18. The IMC will inturn make its own recommendations to the judges who set workers'comp rates. Those rates will be included in the revised workers'comp fee schedule to be published sometime this year.
The IMC meeting is public and will be held at 10 a.m. at theHoliday Inn Crown Plaza Hotel at the Los Angeles InternationalAirport, 5985 W. Century Blvd.