The National Patient Advocate Foundation -- NPAF -- is calling on Congress to Reconsider imaging reimbursement cuts in the Deficit Reduction Act.

Nancy Davenport-Ennis, chief executive officer and founder of the NPAF, stated, "If imaging reimbursement is reduced, patient access to imaging services that stage disease and provide appropriate treatment will be drastically reduced." She called on Congress to reconsider drastic Medicare imaging cuts contained in the Deficit Reduction Act of 2005 (DRA) at an April 5 Capitol Hill staff briefing on the importance of medical imaging in winning the war on cancer.

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Rep. Mike Rogers (R, Mich.), chair of the House of Representatives Cancer Care Working Group, moderated the session panel which featured Davenport-Ennis; Daniel Sullivan, MD, associate director, National Cancer Institute Cancer Imaging Program; Roy Beveridge, MD, a medical oncologist at Fairfax (Va.) Hospital; and Joe Hogan, president and CEO, GE Healthcare.

According to Rogers, who is a 20-year cancer survivor, medical imaging allows early detection, is less invasive, and assists in disease management. However, imaging reimbursement cuts contained in the DRA will limit patient access to the imaging procedures that Rogers and the panel members called a primary reason for the drop in cancer mortality over the last three decades. Particularly in rural areas, the cuts may force many providers to stop offering imaging services or limit the number of Medicare patients that they receive, forcing many patients to travel longer distances to receive imaging care.

The DRA arbitrarily capped the technical component of Medicare reimbursement for physician office imaging to the lesser of the Hospital Outpatient Prospective Payment or Medicare Fee Schedule payment and captures any additional savings achieved via the Centers for Medicare and Medicaid Services (CMS) rule which cut reimbursement for imaging exams on contiguous body parts in the same session by 25% in 2006 and calls for an additional 25% reduction in 2007.

These alarming reimbursement cuts may also stifle research and development of new technologies that are increasingly replacing more invasive, and often more costly, procedures. For example, under the new provisions, Medicare would pay 38% - 69% less for many cutting edge technologies such as the new 64-slice CT scanners which perform cardiac CTA (computed tomography angiography) that produces 3-D images of the heart allowing doctors to pinpoint problems without more invasive techniques.

Drastically reduced reimbursement will leave many doctors financially unable to purchase such updated equipment. The reduced demand for new machines will likely reduce investment in research and development of new technologies.

US Oncology and the National Electrical Manufacturers Association hosted the April 5 Capitol Hill event.NP

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