Recently, the U.S. Centers for Medicare and Medicaid Services announced amendments to the 2015 Medicare Physician Fee Schedule. The ruling typically affects health care providers’ reimbursement for rendered services, but managed to skip over medical imaging to impact radiation oncology.
According to AuntMinnie.com, the MPFS for 2015 has targeted the treatment method for additional payment cuts in the coming six months. Under the proposed rule, this service’s reimbursements would be cut by 4 percent, while payments to radiation therapy centers would be slashed by 8 percent. While there is no clear cut answer as to why this modality has fallen under the axe of CMS, it may be that the agency feels the service is overvalued.
“This is a pre-election sort of rule; CMS is not going out of its way to make enemies,” said Cynthia Moran, executive vice president for government relations at the American College of Radiology, quoted by AuntMinnie.com. “But it does take a bite out of payments to radiation therapy centers and radiation oncology services.”
In addition to radiation oncology, reimbursements for some procedures, like chest X-rays conducted outside of hospitals, could be cut by as much as 6 percent. HealthImaging explained that further cuts include radiology services (2 percent), nuclear medicine (1 percent) and cardiology (1 percent).
Advancements may be causing cuts
While cuts to reimbursement are less than desirable, they may reflect improved efficiencies from transitions to digital imaging from analog film. CMS supports the advancements of PACS workstations, as they can drastically improve clinical services by removing outdated equipment that was expensive to maintain.
As a result of the cuts, the American Society for Radiation Oncology released a statement indicating its concern over the proposal. The ASRO believes that slashing the payments for this treatment could potentially impact patient access to cancer care.
CMS plans to examine payments for secondary interpretations of imaging studies, allowing providers to contribute comments on the appropriateness of the process and its significance to Medicare services. As health care stakeholders aim to reduce instances of repeated imaging procedures, which can expose patients to dangerous levels of radiation doses, the federal agency is trying to determine whether additional readings would cut down on duplicate exams.
The full proposal will be published in the Federal Register on July 11, 2014, with CMS accepting comments from providers until September 2.
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Ronny Bachrach
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