Washington, D.C. - The Medical Imaging & Technology Alliance (MITA) expressed its support for the health policy goals presented in the President's federal budget, and shares a commitment to ensuring that all Americans have access to affordable, quality health care.

However, the association said that the budget's proposed reliance on radiology benefit managers (RBMs) will deny imaging services, and is an ineffective model that undermines the doctor-patient relationship in making health care decisions. If the Medicare program depends on RBMs, it will lead to further reducing seniors' access to life-saving medical services.

MITA said it agreed with the Department of Health and Human Services' (HHS) critique of RBMs. In the June 2008 Government Accountability Office (GAO) report "HHS raised several concerns about the administrative burden, as well as the advisability of prior authorization for the Medicare program. First, the agency said there was no independent data-other than self-reported-on the success of RBMs in managing imaging services. Second, it stated that RBMs' use of potentially proprietary information, including clinical guidelines and protocols for approval of services, may be inconsistent with the public nature of Medicare. Third, the effectiveness of a prior authorization program could be diminished if a high proportion of denied services were overturned through Medicare's statutory and regulatory appeals process. HHS also raised a question about how prior authorization would fit within its current post-payment review program."
"We must ensure that patients have access to the right scan at the right time. The RBM model is the wrong approach and the Administration and Congress should instead build on appropriateness criteria - a successful approach that was established in last year's Medicare law, and which is used by and proven effective in many of the nation's leading health systems," said Ilyse Schuman, managing director of MITA. "Not only is medical imaging integral to best practices and medical guidelines for disease prevention, early detection, diagnosis and treatment, but research has also demonstrated that imaging technologies both improve health outcomes and reduce health care costs when used appropriately.

"As the Obama administration and the Congress take on the important work of health care reform, it is critical that they remember the tremendous amount of value that medical imaging brings to the table," Schuman added.

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