In Connecticut, breast rads feel the pinch of slashed state reimbursement

Amid bitter battles over the state budget, radiologists in the Nutmeg State continue to struggle for the wherewithal to serve Medicaid patients—not least low-income women in need of diagnostic and screening mammography.

Last year the state cut reimbursement for various radiology services, including mammography, to a rate well below the 2007 Medicare fee schedule.

On April 3 the Hartford Courant reported that some radiologists have been muddling through and are now pinning their hopes on like-minded legislators to turn things around.

Others have been unable to absorb the losses and so have stopped accepting Medicaid patients.

“Since the state’s reimbursement cut, radiologists have received $20 for reading a screening mammogram and $25 for a diagnostic mammogram for high-risk patients, a fee that includes other services such as consulting with the referring physician and supervising the technologist,” the paper explains. “In contrast, some private insurers can pay roughly $50 to $57 for a screening mammogram and $65 to $70 for a diagnostic mammogram.”

The article quotes radiologist Michael Crain, MD, who heads a private practice while also serving as radiology director at Middlesex Hospital.

“If the final decision comes down to the fact that this is it, I will most probably stop accepting Medicaid patients,” Crain says. “I have no choice.”

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