Congressmen To MedPAC: Re-Examine Utilization Data

Questioning the validity of its conclusion that medical imaging has comprised a major driver of Medicare spending growth, Reps. Joseph Pitts (R-Pennsylvania) and Frank Pallone Jr. (D-New Jersey) are urging the Medicare Payment Advisory Commission (MedPAC) to "re-examine the data" regarding medical imaging utilization. In a letter sent to MedPAC last week in preparation for the commission’s submission of its June report to Congress, Pitts and Pallone note that while imaging grew at a substantial rate during the early part of the last decade, likely due in large part to new technologies, the growth rate began to slowly decelerate by 2005 and has since decreased dramatically. They also cite a study by the Moran Company, which revealed that according to Medicare claims data, spending on advanced imaging services declined by 19.2% in 2007 compared with 2006 while spending on overall imaging declined by 13.3% compared with the previous year, all due to the Deficit Reduction Act (DRA) of 2005. The Government Accountability Office (GAO) submitted a similar report, which indicates a $1.7 billion reimbursement in the first year of DRA implementation. "Since that time, total spending for imaging has remained modest, with spending in 2008 growing at 2.9% and 2009 levels decreasing by 2.1%,” the Congressmen write. “In addition, spending per beneficiary dropped by 1.5% from 2008 to 2009." They add that as MedPAC contemplates additional changes to payment levels related to imaging, it is important to recognize that the previously scheduled reductions in payment levels for imaging services have yet to be implemented. Accordingly, Pitts and Pallone implore MedPAC "to re-examine the data as it relates to these services prior to finalizing any imaging recommendations and to fully consider additional scheduled payment reductions, prior to making any additional recommendations."