In what radiology advocates are calling a major victory, the Health Care Financing Administration on June 5 announced that it will delay the implementation of its new payment system for outpatient healthcare services, including radiology studies.
HCFA, which administers the Medicare and Medicaid systems, announced that it will delay the effective date of its new outpatient prospective payment system (PPS) until August 1. That gives hospitals and imaging centers an extra 30 days to prepare for the system, which originally had been scheduled to go into effect July 1.
Many imaging providers have been dreading the arrival of the new payment system, which includes a number of controversial provisions. The system is based on ambulatory payment classifications (APCs), which would cut the technical reimbursement for many radiology procedures by about 30%.
In addition, the new PPS reimburses outpatient imaging departments on a flat-fee basis for CT, MRI, and ultrasound studies, regardless of whether or not contrast media is used. As a result, the new system could have a dramatic impact on both facilities that use contrast media and contrast manufacturers.
In Monday's announcement, HCFA said the reason for the postponement was because the agency had missed several important milestones necessary for implementation of the PPS. In addition, the agency said that its informal surveys of the hospital community indicate that a large number of hospitals may not be prepared for the July 1 implementation date. The full text of HCFA's announcement is available at http://www.hcfa.gov/medicare/oppsmssg.htm.
The delay is a victory for the radiology community, according to Cherrill Farnsworth, executive director of the National Coalition for Quality Diagnostic Imaging Services (NCQDIS), which had been pressing for changes to the new system. While the delay only gives the radiology community a 30-day reprieve, the move signifies that HCFA may be willing to relax what up to now has been an intransigent position on making changes to the new scheme.
"It is a sign of weakening of resistance in HCFA to make any kind of change," Farnsworth said.
NCQDIS is working with Congressional representatives and other radiology allies to put additional pressure on HCFA to revise the proposal. Farnsworth is hopeful that the agency will revise some of the more odious provisions in the PPS, such as the contrast issue, which the agency has said it will reconsider.
In Monday's announcement, however, HCFA indicated that it plans to redouble its efforts to make sure the new system is effective August 1. The agency is also asking the hospital industry to not collect deductibles or co-insurance from Medicare beneficiaries beginning August 1 until they are notified of the correct amount of the charges.
By Brian Casey
AuntMinnie.com staff writer
June 7, 2000
Related Reading
Radiology awaits arrival of HCFA's new APC payment system, June 5, 2000
Outpatient rad services could be hit hard by HCFA's new payment system, April 27, 2000
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