Fiscal cliff deal means fiscal squeeze for imaging

While lawmakers managed to avert the fiscal cliff on Jan. 1, imaging took a hit. The one-year Sustainable Growth Rate (SGR) fix is partially funded by an increase in the imaging equipment utilization threshold. The Diagnostic Imaging Services Access Protection Act also slipped off the radar during the last-minute scramble to pass a palatable deal. Finally, the deal cuts payments for some radiosurgery procedures.

The American Taxpayer Relief Act of 2012 prevents a 27 percent Medicare physician payment cut for one year, but the fix dips into imaging’s pockets. The deal increases the technical component equipment utilization threshold for advanced imaging modalities from the current 75 percent to 90 percent beginning January 2014. This provision will garner approximately $800 million in savings to the Medicare program over a 10-year period.

“These cuts will ultimately damage patient access to medical imaging care and may drive up long term costs by delaying diagnosis of illness and disease to later stages where more expansive, and expensive, treatments are required. This move by congress represents a step backward in patient care,” American College of Radiology's Board of Chancellors Chair Paul H. Ellenbogen, MD, said in a statement.

Lawmakers also failed to include H.R. 3269/S. 2347, the Diagnostic Imaging Services Access Protection Act, into the final legislation. This bill would have avoided a 25 percent reduction to the professional component of certain diagnostic imaging services for multiple imaging studies administered to the same patient, by physicians in the same practice setting, on the same day.

Finally, the American Taxpayer Relief Act of 2012 partially pays for the SGR fix by reducing Medicare payments for radiosurgery by $300 million over 10 years. The legislation would lower hospital outpatient payments for radiosurgery involving multi-sourced Cobalt 60, to the level of another treatment modality that uses a linear accelerator to deliver radiosurgery.