The healthcare reform bill released this week by the U.S. Senate Finance Committee would set the equipment utilization rate for Medicare reimbursement of imaging studies at 65%, significantly lower than the 90% level proposed in original versions of the legislation.
Committee chairman Max Baucus (D-MT) on September 16 released the $856 billion healthcare reform bill, which included a provision setting the 65% equipment utilization rate, according to Josh Cooper, senior director of government relations for the American College of Radiology (ACR) in Reston, VA.
"We're very pleased with this rate," Cooper said. "[The shift] is a direct result of negotiations conducted with the Senate Finance Committee by the American College of Radiology and our partner, the Access to Medical Imaging Coalition."
If passed, the utilization rate will remain at 65% for the first four years of the bill's 10-year tenure. During that time an impact study will be conducted, and if it is determined that the rate is cost-effective, it will remain at 65%, Cooper said. If not, the Secretary of Health and Human Services has the prerogative to raise the utilization rate to 75% in 2014.
"The Congressional Budget Office underestimated by threefold the financial impact of the Deficit Reduction Act of 2005," Cooper said. "Something similar may happen with this provision and, if so, that would mean the equipment utilization rate would remain at 65% for the next decade."
Also in the Senate bill is a provision addressing physician self-referral. It would require any physician who owns imaging equipment to disclose that fact to his or her patients and provide a list of alternative facilities where the service can be provided.
Finally, the Senate bill now follows the House legislation regarding the adjustment in the technical component discount on single-session imaging of contiguous body parts, increasing the reduction from the current 25% to 50%. The House bill would set the utilization rate at 75%.
The struggle to protect medical imaging from further cuts is far from over, Cooper said.
"The ACR appreciates the effort Senator Baucus and his staff have made to reduce that 90% equipment utilization rate," he said. "And we look forward to working with them further as the legislative process continues."
Related Reading
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AMIC report attacks utilization rate changes, September 11, 2009
AMIC: Voters oppose imaging cuts, September 9, 2009
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U.S. Senate may drop public healthcare option, July 29, 2009
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