As the American College of Radiology prepares to meet with members of Congress during virtual Capitol Hill Day on Wednesday, the imaging advocate has identified three of its most pressing issues.
The college provided draft documents and other resources for the 350-plus attendees expected to participate in the meetings. Below are key takeaways.
1. Impending Medicare E/M pay cuts
After avoiding potentially “ruinous” reimbursement cuts to the Medicare Physician Fee Schedule for 2021, the ACR wants federal lawmakers to take action and provide added support to ensure “fiscal stability” for physicians and practices in 2022 and beyond.
In a draft document for members, the ACR urges Congress to retain the current 3.75% increase to the MPFS conversion factor and weigh reforms to the payment schedule, including alternatives to statutory requirements for budget neutrality.
It further suggests waiving PAYGO, or pay as you go, requirements connected to the American Rescue Plan Act that would help avoid a planned 4% payment reduction next year, according to a May 13 update to members.
Going forward, the ACR said Congress “must recognize the need for critical reforms to the MPFS system,” notably changes to the budget neutrality system.
2. Technical changes to imaging aspects in PAMA
Next on its agenda is an amendment to the Protecting Access to Medicare Act of 2014, which mandates providers consult appropriate use criteria (AUC) when ordering advanced imaging exams.
“The ACR is concerned that certain claims processing problems at CMS may further delay the program’s implementation and that existing statutory language may be unnecessarily cumbersome for today’s ordering providers,” it noted Thursday.
As such, the college wants Congress to change language within the legislation to remove point-of-care “real-time” claims processing requirements and, instead, replace it with proof that providers consulted with AUC when ordering advanced imaging. Doing so, the ACR said, would allow such data to be collected by decision support tools and reviewed by CMS.
Finally, the radvocate suggested excluding ordering providers working in advanced payment models and those participating in clinical trials from taking part in AUC mandates.
3. Pass the Health Care Provider Protection Act
The pandemic has taken a significant toll on providers around the world, including Lorna Breen, an emergency physician in New York City who committed suicide in April 2020 after weeks of caring for COVID-19 patients early in the crisis.
Congressional lawmakers have since introduced the Dr. Lorna Breen Health Care Provider Protection Act to establish various grants and awareness programs to reduce and prevent burnout and promote mental healthcare.
The ACR urges leadership to advance and pass this bill.
“Ensuring clinicians can freely seek mental health treatment and services without fear of professional setback means such issues can be resolved, rather than hidden away and suffered through,” the radiology group wrote.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.