[Congressional Record Volume 153, Number 75 (Tuesday, May 8, 2007)]
[Senate]
[Pages S5740-S5741]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER (for himself, Mr. Smith, Mr. Kennedy, Ms. 
        Collins, Mrs. Murray, Mr. Isakson, Mr. Kohl, Mr. Coleman, Mr. 
        Casey, Mr. Cornyn, Mr. Menendez, Mr. Burr, Mrs. Lincoln, Mr. 
        Graham, Mr. Harkin, and Mr. Cardin):
  S. 1338. A bill to amend title XVIII of the Social Security Act to 
provide for a two-year moratorium on certain Medicare physician payment 
reductions for imaging services; to the Committee on Finance.
  Mr. ROCKEFELLER. Mr. President, I rise today with my friend and 
colleague from Oregon, Senator Gordon Smith, to reintroduce the Access 
to Medicare Imaging Act. This legislation would place a 2-year 
moratorium on the imaging cuts enacted as part of the Deficit Reduction 
Act, DRA, of 2005, pending the outcome of a comprehensive Government 
Accountability Office, GAO, study on imaging utilization and payment 
within the Medicare Program.
  Each year, millions of Medicare patients receive medical imaging 
services, including X-rays, CT-scans, MRIs, and PET scans, just to name 
a few. Imaging technologies are a critical component of early diagnosis 
and treatment for many life-threatening conditions, like cancer and 
heart disease. Medical imaging equipment allows providers to rapidly 
exchange images across the internet, facilitating greater and timelier 
physician consultation and improving the quality of care received by 
patients.
  For individuals living in rural or medically underserved areas, such 
as many parts of West Virginia, imaging technology is particularly 
important. In West Virginia, access to imaging equipment is a very big 
deal. Without these technologies, many individuals would be denied much 
needed treatment and invaluable peace of mind. Sadly, provisions 
included as part of the DRA leave some of our most vulnerable citizens 
at risk by jeopardizing their access to these imaging services.
  Consider, if you will, the Center for Advanced Imaging at West 
Virginia University. This state-of-the-art facility offers the rare 
integration of clinical imaging with medical research and development. 
Imaging services are provided for patients throughout the State of West 
Virginia and bordering rural regions in Ohio, Maryland, Kentucky, 
Virginia, and Pennsylvania. Because of imaging technology, trained 
medical staff at West Virginia University can take a digital image and, 
within minutes, send a precise copy to a major medical facility in 
Seattle, WA. There, it can be read by a specialist, who can then return 
a written report by email. A few years back this was still science 
fiction, but now it happens every hour, of every day, across the 
country.
  As incredible as these services may seem, and as important as they 
are to the practice of effective clinical medicine, there is a 
perception that imaging services also come with an increased cost. Over 
the past few years, the use of imaging services by Medicare 
beneficiaries has increased significantly. In fact, MedPAC reported in 
March 2005

[[Page S5741]]

that imaging grew at twice the rate of all other physician fee schedule 
services between 1999 and 2003. During that time, MRI and CT procedures 
increased by 15 to 20 percent per year on their own.
  In addition to rising costs, MedPAC further reinforced ongoing 
concerns about potential overuse of imaging services and the sudden 
increase of outpatient-based imaging in primary care settings. Citing a 
lack of training and implementation of imaging guidelines, MedPAC 
called upon Congress to direct the Secretary of Health and Human 
Services to define and execute such standards.

  Given the MedPAC report, imaging reimbursement became an easy budget 
target during the reconciliation debate in 2005. On January 1, 2007, as 
directed by the DRA, payments for medical imaging services delivered in 
a physician's office or imaging center were capped at a rate not to 
exceed the rate paid to a hospital's outpatient department. In some 
instances, this has resulted in a 30-50 percent reduction from previous 
Medicare imaging reimbursement rates and has created questions as to 
the long-term availability of these vital services for Medicare 
recipients.
  I believe the $8 billion in imaging cuts were prematurely added to 
the Deficit Reduction Act in order to meet a budget target and were not 
based on sound public policy. These cuts represent almost a third of 
the total savings included in the Deficit Reduction Act, yet they were 
never debated by Congress. Physicians need imaging technology to ensure 
the best possible health outcomes for their patients, and they deserve 
to be fairly compensated for providing their patients access to this 
revolutionary technology.
  The legislation that I am proposing today along with Senators Smith, 
Kennedy, Collins, Murray, Isakson, Kohl, Coleman, Casey, Cornyn, 
Menendez, Burr, Lincoln, Graham and Harkin would declare a 2-year 
moratorium on the imaging cuts included in the DRA so that both the 
Government Accountability Office and Congress can better assess what 
payment or policy reforms are necessary to maximize the effectiveness 
of the imaging technology available to Medicare recipients. The insight 
garnered from a comprehensive GAO study will be invaluable to Congress. 
In the meantime, however, we cannot stand by and allow our elderly and 
disabled to suffer so that we can meet an arbitrary budget target. I 
urge my colleagues to join with us in supporting this timely 
legislation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1338

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Access to Medicare Imaging 
     Act of 2007''.

     SEC. 2. TWO-YEAR MORATORIUM ON CERTAIN MEDICARE PHYSICIAN 
                   PAYMENT REDUCTIONS FOR IMAGING SERVICES.

       (a) Moratorium.--No payment adjustment shall be made under 
     subsections (b)(4)(A) or (c)(2)(B)(v)(II) of section 1848 of 
     the Social Security Act (42 U.S.C. 1395w-4) during the 2-year 
     period beginning on the date of the enactment of this Act.
       (b) GAO Study and Report on Imaging Services Furnished 
     Under the Medicare Program.--
       (1) Study.--The Comptroller General of the United States 
     shall conduct a comprehensive study on imaging services 
     furnished under the Medicare program.
       (2) Report.--Not later than 1 year after the date of 
     enactment of this Act, the Comptroller General shall submit 
     to Congress and the Secretary of Health and Human Services a 
     report on the findings and conclusions of the study conducted 
     under paragraph (1) together with recommendations for such 
     legislation and administrative actions as the Comptroller 
     General considers appropriate.
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