Final answer on equipment use rate: 75% in 2011

The U.S. Medicare program will use a 75% rate for medical imaging equipment utilization starting in January 2011, after Democrats beat back a Republican amendment that would have stricken the new rate from the healthcare reform bill.

The Senate on Thursday passed a reconciliation bill it received from the House of Representatives that sets the utilization rate -- the rate that equipment is assumed to be in operation at a facility -- from 50% to 75% for all imaging equipment priced more than $1 million, effective January 2011. This rate supersedes the 90% rate the Centers for Medicare and Medicaid Services (CMS) has proposed in various rules in 2009.

As Republicans sought to derail the healthcare reform legislation, Sen. Sam Brownback (R-KS) submitted an amendment to strike the provision from HR 4872, the House version of the reform bill. But the amendment was never offered for vote, according to the American College of Radiology (ACR) of Reston, VA. The House has now confirmed this bill.

On March 21, the House passed the Senate's Patient Protection and Affordable Care Act (HR 3590), and President Obama signed it into law on March 23. This bill allowed for a gradual increase of the utilization assumption rate over a four-year period, from the 2009 rate of 50% to a maximum rate of 75% in 2014.

But also on March 21, the House sent the Senate its Health Care and Education Affordability Reconciliation Act of 2010 (HR 4872), a bill meant to reconcile differences between the two bodies' healthcare reform plans. This is the bill with the provision that raises the equipment utilization rate to 75% starting next year.

The data used to make this change in the utilization rate are flawed, the ACR said, noting that a recent Radiology Business Management Association (RBMA) study found that the national average utilization rate is actually only 54%.

"[The Medicare Payment Advisory Commission (MedPAC)] and CMS have admitted that the survey used to justify [this] utilization rate is insufficient to [change] national policy," ACR said in a statement. "The greater the difference between the rate that a facility actually uses their equipment and the federal assumption, the greater the reimbursement cut to the provider."

By Kate Madden Yee staff writer
March 26, 2010

Related Reading

Healthcare changes headed back to House, March 25, 2010

Obama signs historic healthcare overhaul into law, March 23, 2010

Healthcare reform bill stakes utilization rate at 65%, for now, March 23, 2010

Obama optimistic on weekend healthcare vote, March 19, 2010

U.S. budget analysts say health bill to cut deficit, March 18, 2010

Copyright © 2010

Page 1 of 1162
Next Page