How the Government Shutdown Affects Medical Imaging

It is hard to measure the indirect impact on medical imaging from the overall negative economic consequences of a government shutdown. However, the direct impact on practical day-to-day business operations should be fairly small judging by the contingency plans of various government agencies. Reimbursement for caring for Medicare, Medicaid or Veterans’ Administration patients will not be affected, says the U.S. Department of Health and Human Services. The department also is proceeding with the launch of the Affordable Care Act insurance exchanges today, albeit with half their staff, delays and computer problems. Furthermore, Stage 2 of the HITECH Act financial incentive program for electronic health records (aka, meaningful use) begins as scheduled today for eligible hospitals. Imaging businesses in a tax dispute with the Internal Revenue Service may get a temporary reprieve as the IRS is suspending audits. Those who filed for an extension on their 2012 taxes must still file by October 15. The IRS will be collecting taxes, even as it may be delaying refunds. Recovery Audit Contractor (RAC) activity will continue as normal unless the contractor is at the end of its agreement with the government to furnish auditing services. In general, the U.S. Department of Health and Human Services and the National Institutes of Health advised contractors to follow the terms of their agreement with the government. Facility managers waiting for the results of an Occupational Safety and Health Administration inspection will be waiting until the end of the shutdown. All OSHA investigations are frozen and new inspections will not be made. Radiologists working on a National Institutes of Health funded study will continue to receive grant funds and can apply for more funds. However, new grant applications will only be stored in the system and routine administrative support services on current NIH grants will not be available. Imaging device developers seeking patents will not be affected unless the shutdown drags on for more than a month. The patent office is funded for the next four weeks. The same goes for device developers seeking U.S. Food and Drug Administration approval. Because the FDA is largely funded by fees collected from industry, it should continue close to normal operations.
 The helium supply for MRIs also will be unaffected. The Department of the Interior’s Bureau of Land Management’s contingency plan has employees who work in helium operations staying on the job during the shut down. The U.S. Helium Reserve is currently mandated to shut down next week, but a bill passed by Congress to keep it open is on the president’s desk and he is expected to sign it. It is unclear what will happen with health IT systems for radiology that are seeking certification for stage 2 of the meaningful use program. The Office of the National Coordinator (ONC) is losing almost all of its funding. Of its 184 staffers, only four would remain. The ONC is expected to halt its work on standards and interoperability, privacy and security policy development, clinical quality measures, and maintenance of the Certified Health IT Product List.