House members rally against MedPAC recommendations

A bipartisan group of 61 Members of Congress, led by Rep. Pete Olson (R-TX) of the House Energy and Commerce Committee and Rep. Jason Altmire (D-PA) of the House Small Business Committee, signed and circulated a letter to congressional colleagues expressing concern over imaging cuts recommended by the Medicare Payment Advisory Commission (MedPAC).

In its June report, MedPAC recommended a multiple procedure payment reduction (MPPR) to the “professional component” of successive diagnostic imaging services administered to the same patient, on the same day, in the same setting. This step would slash the reimbursement for physician interpretation and diagnosis. Cuts have typically been applied to the "technical component," or overhead costs of providing exams.

The representatives warned colleagues that this “would set a dangerous precedent for Medicare reimbursement policy.” They added, “These payment cuts are making it extremely difficult for radiologists to keep their practices and free-standing imaging centers open for business and available to patients. Without access to these facilities, patient access to valuable community-based diagnostic imaging services could be compromised and the vast majority of imaging services may be delivered in the hospital setting, potentially at a higher cost to Medicare.”

“This purely cost-cutting move may push many imaging providers, who have already endured massive cuts in recent years, over the edge regarding their ability to provide care in the communities they have served,” said Harvey L. Neiman, MD, CEO of the American College of Radiology. “Cutting professional reimbursement makes no medical sense. Payment to doctors for reading scans is only a small part of what Medicare pays for these exams. Radiologists can’t simply tighten their belt or become more efficient. The time it takes to read exams is relatively constant regardless of whether the patients’ exams are taken separately or all at once.”

MedPAC recommendations are rooted in the belief that mispricing of diagnostic imaging services has led to overutilization. Yet, a review of Medicare claims data by the Moran Company proves that medical imaging growth in Medicare is only 1 percent annually—in line with or below that of other major physician services. Particularly, MRI use is decreasing. Growth in use of CT scans and other advanced imaging is roughly half of what it was even as little as three years ago, according to the research company.

“We are past the point where these types of cuts can be justified in medical terms. I am glad that some members of Congress recognize the detrimental effects that these indefensible cuts will have on their constituents. I urge lawmakers to reject this medically unjustified rationing of care in an area of medicine that is increasingly vital to the well-being of every American,” said Neiman.

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