February 7, 2006
Budget-Cutting Bill Impacts Payments to Physicians’ Offices Beginning in 2007
RESTON, Va.—SNM opposes a provision of the federal Deficit Reduction Act that impacts its members: payment caps to physicians’ offices with imaging equipment that are set to begin in 2007.
The five-year, $39 billion budget-cutting bill, which is scheduled to be signed into law Feb. 8 by President George W. Bush, calls for payment caps on imaging and computer-assisted imaging services. “The bill limits reimbursement for the technical (as opposed to the professional or interpretation) component to what would be paid under the hospital outpatient prospective payment system (HOPPS) or Medicare fee schedule payment (MFSP), whichever is less,” explained Gary L. Dillehay, M.D., chair of SNM’s Coding and Reimbursement Committee. The caps apply to molecular and nuclear imaging (including positron emission tomography), X-rays, ultrasounds, magnetic resonance imaging, computed tomography and fluoroscopy, said the associate professor of radiology at Loyola University Medical Center in Maywood, Ill.
In addition, the act eliminates the 4.4 percent reduction in claims payments for physicians’ services, freezing the payment at 2005 rates. Officials at the Centers for Medicare and Medicaid Services indicate that the freeze will be applied retroactively to services paid between Jan. 1 and the date of the bill’s enactment.
“All Americans understand the need to be fiscally responsible; however, this bill’s imaging provisions affect the care of patients,” said SNM President Peter S. Conti, M.D., Ph.D., professor of radiology, clinical pharmacy and biomedical engineering at the University of Southern California, Los Angeles. “Patients deserve convenient access to needed molecular and nuclear imaging services, and in the future they may find fewer imaging offices available as independent establishments close due to financial challenges,” added Conti, who as SNM president represents more than 16,000 physician, technologist and scientist members. “SNM is currently working with related associations and industry leaders to modify the bill’s 2007 provision,” added the director of the PET Imaging Science Center at USC’s Keck School of Medicine.
The Congressional Budget Office estimates that Medicare and Medicaid changes would save $11 billion over five years, with imaging services accounting for at least a quarter of that figure.
SNM is an international scientific and professional organization of more than 16,000 members dedicated to promoting the science, technology and practical applications of molecular and nuclear imaging to diagnose, manage and treat diseases in women, men and children. Founded more than 50 years ago, SNM continues to train physicians, technologists, scientists, physicists, chemists and radiopharmacists in state-of-the-art imaging procedures and advances; provide essential resources for health care practitioners and patients; publish the most prominent peer-reviewed resource in the field; sponsor research grants, fellowships and awards; and host the premier annual meeting for medical imaging. SNM members have introduced—and continue to explore—biological and technological innovations in medicine that noninvasively investigate the molecular basis of diseases, benefiting countless generations of patients. SNM is based in Reston, Va.; additional information can be found online at http://www.snm.org.