Medicare Imaging Cuts Off Base, ACR says

November 4, 2011
Diagnostic Imaging Staff

The Centers for Medicare and Medicaid Services’ 25-percent cut of multiple procedure payment for image interpretation is “unfounded and potentially dangerous,” the American College of Radiology said.

The Centers for Medicare and Medicaid Services’ 25-percent cut of multiple procedure payment for image interpretation is “unfounded and potentially dangerous,” the American College of Radiology said. 

CMS had planned a 50 percent cut, but backed off in the face of additional ACR-supplied data and what the ACR described as “a furious response from the imaging community.” But the final rule expanded the payment reduction to include multiple providers within the same group practice – a surprise that the ACR said “violates the spirit of the rulemaking process and indicates that CMS fundamentally misunderstands the practice of medicine.”

ACR officials said the multiple procedure reduction will affect the most vulnerable of Medicare beneficiaries: people suffering from multiple trauma, stroke patients and those with widespread cancer. Such patients often require multiple scans to survive serious illness and injury, the interpretation of which can often require the expertise of several different radiologists, they added.

“This extension of the multiple procedure payment reduction to include physicians in the same group practice was not specifically included in the 2012 Medicare Fee Schedule Proposed Rule. No efficiencies in care support a funding cut when different physicians in a group practice interpret separate imaging scans for the same patient. There is no scientific support for this action. The Centers for Medicare and Medicaid Services should rescind it immediately,” said John A. Patti, MD, chair of the ACR board of chancellors.

Medicare funding for imaging scans has been cut $5 billion since 2007. The Obama Administration recommended to the congressional supercommittee $1.3 billion more in imaging cuts. This may force many suburban and rural imaging providers to close, causing many seniors to travel farther and wait longer to receive care, the ACR says.

There is no publicly available evidence to support a 25 percent reduction to physician interpretation payments in general, the ACR said, citing a recently published study proves that any efficiencies in the multiple procedure setting are highly variable and, at most, total one-fifth the cost of what CMS contends.

The ACR called on Congress to pass the Diagnostic Imaging Services Protection Act (H.R. 3269), which would block this multiple procedure payment reduction until and unless Medicare produces a study that would support such a cut in care.