Industry stakeholders are working hard to convince the Centers for Medicare and Medicaid Services to put a stop to a plan that would negatively affect reimbursement rates.
The Medical Imaging & Technology Alliance (MITA), an industry lobby, submitted a comment letter to CMS opposing its Hospital Outpatient Prospective Payment System (OPPS) 2014 rule that would use separate cost centers to calculate reimbursement for CT and MR.
"The proposed policy results in payments that lack face validity and will result in absurd reimbursement rates by which CMS would pay hospitals nearly the same rate for advanced CT imaging as it would for X-ray," said Gail Rodriguez, executive director of MITA, in a statement.
In the letter, MITA stated that the payment model will result in inaccurate payment rates and substantial Medicare reimbursement cuts for these imaging modalities in the hospital setting. Essentially, it undervalues the costs of advanced imaging services, where CT would be paid the same as X-ray, and would lead to a substantial reduction in reimbursement for these services in the hospital setting.
On a positive note for opponents of the ruling, the Advisory Panel on Hospital Outpatient Payment recommended that CMS delay implementation of the rule until a full analysis can be reviewed and the impact could be fully understood.
"Given that CT and MRI services are capital-intensive, and that allocation of capital costs within the cost reports is complex and prone to error, MITA urges CMS to heed the HOP Panel's recommendation to hold on implementation of the proposal until the data can be further reviewed," said Rodriguez.
