President Barack Obama's proposal to trim trillions from the deficit and hundreds of billions from Medicare also puts advanced imaging services in the budget-cutting crosshairs.

In the proposal, the government hopes to realize about $1.3 billion in savings by raising the assumed utilization rate on some imaging equipment and by requiring referring doctors to first get authorization, likely from a radiology benefits management service, before ordering a scan.

But these ideas are not new, and they are, as expected, not popular in the imaging community.

"In Washington, there is a dearth of new thinking," Cynthia Moran, Assistant Executive Director of Government Relations with the American College of Radiology, which has about 34,000 members, told DOTmed News, when we spoke this week. She said the calls for raising the utilization rate and pre-authorization for imaging have been floating around the Capitol in one form or another for years.

The administration's proposal, revealed Monday, which includes roughly $320 billion in cuts from Medicare and Medicaid, now heads to Congress. There, Moran says the real action will take place in the so-called supercommittee -- a team of 12 Senators and members of Congress that has to hammer out a plan to slash $1.2 trillion from the deficit by Thanksgiving. The proposal then must be voted on in a simple yea-or-nay vote by Christmas.

"This is no longer the president's game," Moran said.

But the suggestions still are a broad and powerful outline which Congress could follow. In any case, Moran says it could help cast the shape of the debate.

Earlier in the summer, for instance, there was talk of raising the eligibility age for Medicare up from 65 to 67. But those painful, large-scale conversations have been ditched in an effort to simply squeeze out money where possible, according to Moran.

"The regrettable thing is the supercommittee has an opportunity to think in big terms, to really try to move the needle and make significant, systemic changes to the entitlement programs," Moran said. "And I think the rhetoric of the last few days from the White House, from congressional leadership, ensures the supercommittee, instead of thinking big, will think: 'What's the least amount we can do to meet this obligation, then get the hell out of Dodge?'"

The new proposals

The administration says the two-part plan should save Medicare about $1.3 billion. The first part, which the government estimates will save $400 million, involves increasing the utilization rate for advanced imaging services -- which in this context, likely means MRI, CT and nuclear medicine.

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