The Medical Imaging & Technology Alliance (MITA) has called on the Centers for Medicare & Medicaid Services (CMS) to reject the Medicare Payment Advisory Commission's (MedPAC) recommendations for significant changes to physician reimbursement rates for advanced medical imaging procedures.
MITA stated that the recommendations in MedPAC's annual report to Congress were based on flawed and insufficient data, set unrealistic and arbitrary standards for the use of medical imaging and threatens access to life-saving medical services.
"Based on insufficient data and analysis, the MedPAC report makes recommendations that will lead to dramatic Medicare cuts for imaging and have dire consequences for the diagnosis, treatment and care of patients," said Ilyse Schuman, managing director of MITA.
The alliance said that MedPAC itself acknowledged in its report that it lacked the necessary data required by law to support a recommendation for significant change to the medical equipment "use factor standards," which guide Medicare reimbursement rates. "We recognize that [a change in use factor standards] would require a change in statute because the Balanced Budget Act of 1997 requires CMS to use ‘actual data' on equipment use" to calculate the use rate, according to the report.
In addition, MITA said that MedPAC's survey, which was used to guide its recommendations, excluded key factors that "greatly influence imaging utilization rates; most notably the health and age of patients, which are the two most important factors accounting for patient preparation time -- the single biggest determiner of the length of an imaging appointment, and ultimately utilization rates especially in regards to the Medicare population."
MITA has called upon CMS and the Department of Health and Human Services (HHS) to work with the medical imaging community to collect accurate data on medical imaging use to help shape policy decisions.
"Setting a standard for medical imagining that is simply not sustainable without the accurate data to support it will be detrimental to providing appropriate medical care. Imaging technology allows accurate data to be collected that can assist policymakers in making better informed decisions about utilization rates and reimbursements," Schuman said. "We believe that, working in cooperation with HHS and CMS, we can collect data to ensure accurate and fair Medicare reimbursement formulas that will not jeopardize quality care for patients."