Congressional hearings focus on DRA worries, conflict between specialties

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Congressional hearings this week have put on display both the power struggle over medical imaging, and general anxieties over the coming Deficit Reduction Act (DRA) 2005 cuts to reimbursement. The purpose of the hearings was for the House Energy and Commerce Committee to gather information regarding the boom in medical imaging use and expected cuts in Medicare reimbursement started in 2007.

Conflicting testimony involved parties representing both radiologists and cardiologists. Cardiology has made the healthcare imaging picture more complicated, so to speak, because of the rising use of advanced imaging modality use within the specialty, the Houston Chronicle reports.           

One idea put forth was that imaging was being overused due to "entrepreneurial zeal, instead of clinical appropriateness" which was provoking an overall increase in costs, said John Donahue, chief executive of radiology-benefits-management company National Imaging Associates, the Chronicle reports. Donahue also referenced the problem of physician self-referral.          

Bucking the common line from imaging professionals concerned over the DRA, Donahue said that the cuts could “admirably” provide cost control brought on by unnecessary imaging, the Chronicle reports.
Countering this, the head of Duke University’s division of cardiovascular Pamela Douglas, PhD, testified that the DRA would bring on an overall drop in care quality and stated that lawmakers have the responsibility of making "sure policies are driven by what is best for the patient, not solely by budgetary constraints," the Chronicle reports.

Generally, the battle lines that exist between some radiologists and cardiologists largely have to do with different doctor groups in conflict about who does what imaging.

The Access to Medical Imaging Coalition (AMIC) – a broad coalition of physicians, patients, and providers working to delay $8 billion of imaging payment reductions included in the 2005 Deficit Reduction Act – released a statement this week encouraging further review of the DRA changes before they are implemented.

"Even though today's hearing was not focused on DRA-'05 imaging payment reductions, Members of Congress repeatedly expressed concern over how the DRA cuts will affect patients, including those in rural and medically underserved areas," said Tim Trysla, executive director of AMIC. Trysla said he was pleased that many of the Representatives on the panel urged passage of H.R. 5704, a bill recently introduced by Rep. Joe Pitts and more than 50 other Members of Congress calling for a two year moratorium on the DRA cuts while the Government Accountability Office analyzes the impact on patients.      

In response to questions from the Subcommittee, MedPAC Chairman Glenn Hackbarth said that MedPAC had not yet evaluated the potential DRA impact. Herb Kuhn, CMS director of Medicare Management, echoed Hackbarth’s sentiments and stated that the agency would take the potential impact on patient access into account when developing regulations to implement the DRA reductions.