[Congressional Record Volume 158, Number 63 (Monday, May 7, 2012)]
[Senate]
[Page S2916]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
DIAGNOSTIC IMAGING SERVICES
Mr. CARDIN. Madam President, I have introduced the Diagnostic Imaging
Services Access Protection Act of 2012, joined by my colleague from
Louisiana, Senator David Vitter. Our goal is to preserve Medicare
beneficiaries' access to life-saving advanced diagnostic imaging
services, such as magnetic resonance imaging, MRI, computed tomography,
CT, and ultrasound.
Let me explain why this legislation is necessary. Medicare
reimbursement for radiology services is based on two components:
technical and professional. The technical component comprises the cost
of equipment, nonphysician personnel, and medical supplies associated
with the imaging process. The professional component is calculated by
factoring in the radiologist's time, effort, and skill involved in
interpreting images, rendering patient diagnoses, and reporting the
findings in the patient's medical record. In recent years, the Centers
for Medicare and Medicaid Services sought to control imaging growth by
cutting reimbursement for the technical component--reducing payment for
multiple imaging services administered by the same physician to the
same patient during a single office visit. This policy is referred to
as the multiple procedure payment reduction, or MPPR. It is designed to
take into account the efficiencies achieved by doing same-day
procedures on the same patient, and for the technical component of
radiology, it makes sense.
However this year, CMS decided to apply the MPPR to the professional
component as well. The 2012 fee schedule rule, which took effect on
January 1, cut the professional component reimbursement for
radiologists by 25 percent for additional images. This payment
reduction ignores the realities of medical practice. It is not
supported by sound data, nor was it developed with meaningful physician
input. Because each imaging study produces its own set of images that
require individual interpretation, radiologists are ethically and
professionally obligated to expend the same amount of time and effort
interpreting each one, regardless of the number of images, the section
of the body being examined, or the date of service.
Further, because radiologists are referral-based physicians who
rarely order the studies they interpret, MPPR is an ineffective tool to
reduce inappropriate utilization. Beneficiaries receiving multiple
imaging studies often represent the sickest and most complex cases.
They may have advanced cancer or be recovering from a stroke, serious
car accidents, multiple gunshot wounds, or other forms of deadly
trauma.
Not only will CMS' flawed policy disproportionately affect the most
vulnerable patients, it may also create incentives to shift services
away from the private practice setting, where the physician fee
schedule applies, to the more expensive hospital outpatient setting.
Our legislation will ensure that CMS does not arbitrarily undervalue
the role of the radiologist within the health care delivery system. It
would cancel the MPPR cut to the professional component of radiology
services through the end of 2012 and prevent it from taking effect in
future years, pending more comprehensive study of the matter.
Specifically, the Secretary of Health and Human Services would be
prohibited from taking this action unless the reduction is based on the
data, analysis, and conclusions of an independent expert panel convened
by the Institute of Medicine.
A similar bill, HR 3269, has been introduced in the House of
Representatives and it enjoys the strong bipartisan support of more
than 240 cosponsors. I urge my colleagues to support this bipartisan
and budget-neutral approach to preserving patient access to community-
based diagnostic imaging services.
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