House healthcare reform bill calls for 75% increase in imaging utilization

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Democrats in the U.S. House of Representatives unveiled their healthcare reform legislation Friday, calling for a 75 percent increase in the equipment utilization rate and an increase of 25 to 50 percent in the reduction of the technical component of imaging for multiple procedures.

The 852-page bill suggests an increase of 75 percent (rather than the current 50 percent) rate of utilization of imaging equipment when computing the number of practice expense relative value units. Under section 1147, the legislation also recommended a "discount" in the technical component on single-session imaging that involves consecutive body parts by increasing the reduction in expenditures attributable to the multiple-procedure payment from 25 to 50 percent.

The imaging industry has been working to oppose any increase in imaging equipment use rates. Specifically, the Access to Medical Imaging Coalition (AMIC) is urging anyone who visits its site to write a letter to Congress or President Barack Obama opposing these proposals.

Last week, the Radiology Business Management Association (RBMA) released data demonstrating that the use rate of diagnostic imaging equipment in an outpatient setting is approximately one half the amount claimed by the Medicare Payment Advisory Commission (MedPAC) and the Obama Administration. Obama recently recommended that the Centers for Medicare & Medicaid Services (CMS) base its reimbursement formula on a 95 percent utilization rate for advanced imaging equipment. MedPAC has recommended a 90 percent utilization rate for diagnostic imaging equipment that costs more than $1 million.

However, RBMA data showed that that imaging equipment in rural regions of the United States operates only 48 percent of the time an office is open, while equipment in non-rural areas operates 56 percent of the time a center is open for business. The survey assessed 261 imaging machines in 46 centers, both rural and urban.

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Under section 1305, the bill suggested adding coverage and waiver of cost-sharing for preventive services, which includes diabetes outpatient self-management training services, as well as cardiovascular screening blood tests and diabetes screening tests.

There also are suggestions for modifying the Physician Quality Reporting Initiative (PQRI), requiring the Health and Human Services Department (HHS) secretary to develop and implement a mechanism to provide timely feedback to eligible professionals who, with respect to a reporting period, report data on quality measures that have been established under the physician reporting system, no later than Jan. 1, 2011. The bill also would require the HHS secretary to develop a plan to integrate clinical reporting on quality relating to the meaningful use of EHRs no later than Jan. 1, 2012.