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Medicare imaging cuts attached to trade bill

by Brendon Nafziger, DOTmed News Associate Editor | June 30, 2011
Imaging groups slammed a provision attached to a trade bill that would increase the assumed utilization rates for MR and CT for Medicare payments, resulting in cuts to providers.

The bill, announced Tuesday, puts into effect free trade agreements with South Korea, and includes an extension on a program to re-train U.S. workers affected by the increased competition. It's coming before Congress with similar trade agreements for Panama and Colombia.

But as one of several offsets to help pay for the legislation's costs, the bill calls for increasing the assumed equipment utilization rate for advanced imaging services from 75 percent to 80 percent in 2012, and then from 80 percent to 90 for 2013 and subsequent years.

These rates reflect how long the Centers for Medicare and Medicaid Services assumes equipment is used when an imaging center is open. Ninety percent utilization assumes the unit is working about 45 hours a week. These rates are then used to set the technical component for practices.

According to the Access to Medical Imaging Coalition, the Medicare cuts are expected to total around $400 million.

The Medical Imaging & Technology Alliance, an imaging manufacturer's lobby, quickly moved to denounce the offset, saying it could hurt providers already struggling to keep their centers open after a series of recent reimbursement cuts.

"This should be about providing the right reimbursement to preserve health care access, not about filling a funding hole in an unrelated trade bill," David Fisher, executive director with MITA, told DOTmed News.

The group said they learned about the proposed cuts Tuesday, and were making calls around the Hill to convince lawmakers to oppose it.

Imaging spending cuts aside, the trade bill faces a fight in Congress, as some Republican leaders oppose linking the free trade agreements with the extension of the Trade Adjustment Assistance.

However, the free trade agreements with the three countries could boost U.S. exports by $13 billion, according to U.S. International Trade Commission estimates.

Imaging on the chopping block

The bill comes only weeks after a Medicare Payment Advisory Commission report asked Congress to get Medicare to rein in spending on advanced imaging. In its report, the think tank called for high-using referring doctors to first get prior authorization before ordering imaging studies.

But MedPAC's suggestions drew opposition from radiology groups and even from some lawmakers. A letter signed by 61 congressmen pledging resistance to imaging cuts just made the rounds on the Capitol.

MITA said the cost-cutting push derives from an outdated belief that advanced imaging procedures are still experiencing the rapid-fire growth they enjoyed in the late 1990s and early 2000s. Even according to MedPAC's report, advanced imaging rates have flattened, only growing one-tenth of one percent from 2008 to 2009, Fisher observed.

"That's not explosive growth," Fisher said. "What people have caught in their mind is something from a decade ago before all these cuts happened."

The bill, the United States-South Korea Free Trade Agreement Implementation Act, heads for the Senate Finance Committee Thursday.

Daniel Mirkin

This is what is wrong with our system

June 30, 2011 05:23

Imaging has nothing to do with trade with Korea. Bills should address one item at a time and be restricted to 10 pages. If you can't say it in 10 pages then it is probably a stupid law.

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