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Obama's deficit plan includes $1.3 billion hit to imaging

by Brendon Nafziger, DOTmed News Associate Editor | September 20, 2011
Credit: White House/Samantha Appleton
President Barack Obama's proposal to slash more than $3 trillion from the deficit includes changes to Medicare reimbursements for advanced imaging services that the government says could save $1.3 billion over the next 10 years.

It also requires mandatory prior authorization for advanced imaging services by 2013.

The plan, released Monday, calls for a mix of tax increases on the wealthy and corporations and cuts to entitlement spending and other programs to pay off the country's debt while also supporting a bill designed to create American jobs.
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The administration has scheduled close to $320 billion in cuts to Medicare and Medicaid, although the plan assumes Congress figures out a fix to the sustainable growth rate, a physician payment formula which is set to drop a massive reimbursement cut should it go into effect next year.

And tucked within these billions of dollars of cuts is also a substantial snip to medical imaging.

Starting in 2013, under the suggestion of MedPAC, the proposal calls for increasing the utilization rate for advanced imaging (likely MRI, CT and nuclear medicine), to reflect the "higher levels of utilization of certain types of equipment." The administration estimates this will save about $400 million over the next decade.

Also starting in 2013, the proposal calls for doctors to get prior approval before ordering expensive imaging studies because of concerns over "unwarranted use." This plan, which it says was inspired by Government Accountability Office recommendations, would save $900 million over the next 10 years.

Still, the legislation is meant to ensure most sectors carry some of the sacrifices. For instance, the nearly $1.5 trillion in taxes it aims to raise come partly from letting Bush-era tax cuts on those earning more than $250,000 a year expire, and partly from new taxes on those who earn primarily through investments.

And although it does include Medicare cuts, it doesn't raise the Medicare retirement age, a plan that was bandied about earlier. Obama has also said he would veto any Medicare cuts that weren't packaged with an increase on taxes to the rich.

"We cannot afford the finger-pointing and kicking the can down the road. If we are all willing to sacrifice a little to put our fiscal house in order, then no one will have to sacrifice a lot," the White House said in the proposal submitted to Congress.

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