GE, Siemens pledge to fight imaging pre-authorization plan

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GE and Siemens intend to lobby Congress to block President Barack Obama's plan to require diagnostic imaging pre-authorization for Medicare beneficiaries.

In separate interviews with Bloomberg, the companies pledged to fight a plan to require approvals from a private radiology benefit manager (RBM) before Medicare will pay for imaging. The White House said the measure would save $260 million over a decade, money that would aid Obama's plan to expand health coverage.

Such a measure may hinder equipment sales that accounted for more than half of GE's $17.4 billion in healthcare sales last year, and more than €262 million ($328.7 million U.S.) in profit in the fiscal first quarter for Siemens, reported Bloomberg.

RBMs will "actually hamper access and add administrative cost" to Medicare, Mark Vachon, president of GE Healthcare's Americas' division, told Bloomberg. "Having a system that gets between physicians and patients is probably not something we'd be supportive of."

If Congress approves, Obama's plan would be the latest attempt to rein in Medicare imaging costs, which more than doubled to $14.1 billion from 2000 to 2006, putting Medicare on par with most private insurers, who already require prior approvals, reported Bloomberg.

Doctors are increasingly owners as well as users of scanning equipment, giving some an incentive for unneeded tests, the Government Accountability Office (GAO) found in the report. Imaging use "varied substantially across geographic regions, suggesting that not all utilization was necessary or appropriate," the GAO said.

The American College of Radiology (ACR) also opposed the White House plan, though it acknowledges a need to cut back on unneeded scans. The problem could better be handled with doctor training than employing benefit managers with a profit motive, according to John Patti, a thoracic radiologist at Massachusetts General Hospital in Boston, Bloomberg reported.

"Any time you put a middleman or a broker between physicians who are trying to care for their patients, you're going to run the risk of impeding care," said Patti, vice-chairman of the ACR board of chancellors.

The GAO recommended Medicare follow private insurers, who turned to third-party RBMs as costs began rising in the 1980s and 1990s. The managing services, led by units at Indianapolis insurer WellPoint and Magellan Health Services of Avon, Connecticut, cut growth in imaging costs to 5 percent a year from as much as 20 percent, the GAO said, according to Bloomberg.

Vachon said that Obama's plan to spend $19 billion upgrading doctors' computer systems will do more to cut unwarranted imaging, by ensuring physicians have access to new medical guidelines, he said.

Congressional leaders in Congress have yet to take a stand on the imaging plan, so it is too soon to say how it may fare, according to Siemens, reported Bloomberg.