Coalition Contests Proposed Imaging Payment Cuts

The Access to Medical Imaging Coalition is hotly contesting proposals to curtail Medicare payments for medical imaging tests, asserting through a report that such a move likey would pack no money-saving punch. Medicare's independent payment advisory body wants physicians who appear to order a high volume of tests to be required to obtain prior authorization if the tests are to be reimbursed. However, the report—prepared for the coalition by The Moran Company, a health care research and consulting firm—alleges that a better strategy would be for Congress to encourage the adoption of "decision-support tools" by physicians, nurses and other healthcare professionals. “A conversation with the Congressional Budget Office (CBO) indicates that the savings CBO had previously scored from prior authorization for imaging purposes would now be considered already present in the budget baseline,” the report says. “We conclude that CBO might determine that the impact of increasing utilization of decision support tools would similarly be part of current baseline activities.” The report also underscores the possibility that any returns from prior authorization may prove to be significantly “smaller than the operating costs of conducting these programs." Moreover, expanding upon the decision tools concept, the report points to evidence its authors believe indicative of the fact that the tools are efficacious when available — and when they are used. Nonetheless, the authors write that the vast majority of physicians who order diagnostic imaging services are neither exposed to the tools at the present time nor expected to utilize them. http://rightscanrighttime.org/wp-content/uploads/2011/10/AMIC-Final-UM-Report-101820114.pdf