The American College of Radiology (ACR) is continuing to lobby for changes in several provisions in both the House and Senate versions of healthcare reform.
In a letter coinciding with the August congressional recess, James Thrall, MD, chairman of the ACR Board of Chancellors, told ACR members that ACR “has been working hard to eliminate or alleviate” provisions in both the House and Senate that “specifically and significantly affect the practice of radiology.”
One area of particular concern to ACR is a provision in the House that increases the imaging utilization assumption rate from 50 percent to 75 percent for the reimbursement of the technical component (TC) of advanced diagnostic imaging services. On the Senate side, a white paper released in June proposes raising the rate to 90 percent, but that is not yet part of any legislation.
“These proposed changes in the TC formula would result in significant reimbursement reductions for those who own advanced modality equipment in an office setting or IDTF [independent diagnostic testing facility],” wrote Thrall, who added that ACR, along with the Access to Medical Imaging Coalition (AMIC), has been meeting with congressional members and staff to reduce the proposed increase.
The House bill includes another provision to increase the TC multiple procedure discount from 25 percent to 50 percent—an increase, Thrall said, ACR staffers believe will also be included in the Senate bill. According to Thrall, the proposed increase is not based on data, and has been proposed twice—and withdrawn twice—by the Centers for Medicare & Medicaid Services (CMS) due to lack of evidence.
The ACR also is fighting a proposal, being considered in the House and Senate, to establish an independent, non-partisan body of health experts that would make payment and coverage decisions for Medicare providers. Thrall wrote that the ACR believes that such a panel would take away the ability of physicians to collectively participate in the formulation of Medicare policy and put too much power in the hands of a few unelected officials.
Finally, Thrall reminded members that the ACR is continuing to work with Reps. Anthony Weiner, D-N.Y., and Bruce Braley, D-Iowa, in an effort to close the in-office ancillary services exception loophole in the Stark Law.