Imaging cuts in Medicare fee schedule: An access catastrophe and danger to patients

Nov. 2 -- Medical imaging cuts contained in the 2010 Medicare Physician Fee Schedule will restrict life-saving imaging care to large hospitals, produce longer commutes and wait times to receive care, and cause life threatening delays in diagnosis and treatment of cancer and other serious illnesses.

"These short sighted, unfounded and misguided cuts will imperil community based imaging, restrict access to cutting-edge imaging scans, and delay diagnosis of cancers and other critical conditions which may ultimately cost lives," said James H. Thrall, MD, FACR, chair of the American College of Radiology Board of Chancellors. "Many hospitals are not equipped to handle the substantial influx of patients that could result from the inevitable closure of rural and suburban imaging facilities caused by these cuts. Wait times will surge. Access will plummet and lives may be lost due to these ill-advised cuts.

Specifically, the Centers for Medicare and Medicaid Services will raise the imaging equipment utilization rate assumption, the time during office hours that imaging equipment is assumed to be in operation, from the current 50 percent rate to 90 percent. However, a recent Radiology Business Management Association (RBMA) study found that rural providers use scanners only 48 percent of office hours and that the national average is only 54 percent. This assumption is a major factor to determining reimbursement. The wider the gap between the new mandated 90 percent rate and the actual time a provider uses scanners, the deeper the cut.

CMS will also implement new practice expense data collected through the Physician Practice Information Survey (PPIS) further decreasing reimbursement to life saving imaging CT and MRI scans. The data from the PPI survey, based on a limited amount of survey responses, are not as robust as that from the ACR Socioeconomic Monitoring Survey (SMS) and not representative of practicing radiologists. The costs of the practice of radiology in the office setting are significantly underrepresented in the PPI survey.