www.fdanews.com/articles/62642-dra-cuts-will-lower-imaging-procedure-reimbursements-group-says

DRA CUTS WILL LOWER IMAGING PROCEDURE REIMBURSEMENTS, GROUP SAYS

September 19, 2006

An organization of radiologists is pointing to a new report that shows an overwhelming percentage of radiology procedures would be reimbursed at below the cost to provide them if related provisions in deficit-reduction legislation go through.

The Moran Report, released Sept. 18, shows that 87 percent of procedures subject to Deficit Reduction Act (DRA) imaging cuts would be reimbursed at estimated rates below what it costs physicians to provide the exam in the in-office setting, according to the American College of Radiology (ACR). "For some procedures, the report found that Medicare would reimburse providers less than 20 percent of the cost of providing the service," the group said.

The report shows the DRA imaging cuts are "extreme, far reaching and ill-advised," said Arl Van Moore, chair of the ACR's Board of Chancellors in a Sept. 18 statement.

The findings in the Moran report were based on Medicare claims data and 2006 payment rates from the Centers for Medicare & Medicaid Services' (CMS) Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Payment System (HOPPS) to make cross-site spending comparisons and to assess the DRA reductions in relation to the costs of performing the procedures, the ACR said. The report also factored in the expected volume in both the physician office and hospital outpatient settings, but did not take into account proposed CMS changes in the physician fee schedule or the HOPPS for 2007, the group said.

The report also found that overall imaging spending in HOPPS and MPFS systems is now virtually identical prior to DRA, "contradicting the view that the physician fee schedule provided excessive payments compared to the hospital outpatient payment system," the ACR said.

The ACR wants Congress to pass the Access to Medicare Imaging Act (H.R. 5704 and S. 3795), which calls for a delay in the cuts pending a comprehensive analysis by the Government Accountability Office.

The Moran Report can be viewed at http://64.78.60.33/reports/docs/moranreport_mainbody.pdf (http://64.78.60.33/reports/docs/moranreport_mainbody.pdf).