Congressional budget cuts hit radiologists

While Republicans and Democrats each claimed victory Wednesday in the contentious battle to pass a budget resolution, radiologists on both sides are declaring themselves the losers.

By a 51 to 50 vote, Senate Republicans voted to cut federal spending by nearly $40 billion over five years. A big chunk of the money the government hopes to save will come out of the pockets of radiologists.

"Regrettably... a slim majority in the Congress has voted ... to extract over $11 billion in savings out of the Medicare and Medicaid programs," said Dr. James P. Borgstede, chair of the American College of Radiology board of chancellors, in a statement.

The Medicare reimbursement cuts for out-of-hospital medical imaging procedures may force many physicians to stop offering needed imaging services and limit the number of Medicare patients they accept, according to the ACR.

The bill, which must return to the House because of procedural maneuvers by Democrats, caps the technical component reimbursement for physician office imaging. The APC reimbursement for certain imaging procedures, such as MRI and PET, will be significantly lower than current payments under the Medicare physician fee schedule.

This change, if the bill is passed, would take effect in January 2007.

"Congress essentially took a meat axe to Medicare to curtail payment for imaging services. It's very arbitrary and not done in a careful manner," said Thomas Greeson, a healthcare lawyer with Reed Smith LLP in Falls Church, VA.

Earlier this year, Congress was briefed by the Medicare Payment Advisory Commission (MedPAC) on possible ways to rein in imaging costs. The ACR supported those recommendations. The Budget Reconciliation Bill, however, tramples over the MedPAC advice.

"For our elected officials to ignore recommendations made by the experts in this area in favor of draconian cuts is extremely shortsighted and will do far more harm than good," Borgstede said.

Earlier lobbying efforts by the ACR and other medical organizations stopped--at least for a year--a planned reduction of 4.4% in the Medicare conversion factor. Congress is now trying to find ways to fill that gap.

"Ironically, Congress may find that these short-term cuts will actually increase, not decrease, health costs over the long-term," said Robert Britain, vice president of medical products of the National Electrical Manufacturers Association. "Imaging generates cost-savings through less-invasive care, early detection, and fewer complications, and such savings could be threatened by these cuts."

Final action by the House on the bill will be delayed until early January.

For more information:

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CMS proposes imaging payment cuts, extends self-referral law to nuclear medicine

ACR calls report on skyrocketing imaging distorted