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As President Obama travels to town halls across the country to push his healthcare reform, patients and industry groups travel to the Capitol to voice their dissent. Proposed reimbursement cuts to imaging was the subject of the Medical Imaging & Technology Alliance's (MITA) visit to the Hill on July 29.

The alliance protested the proposed cuts in partnership with patient advocacy groups. Those advocacy groups also submitted a letter to the Senate Finance and House Tri-Committees that expressed opposition to an increase in the use rate assumption for imaging equipment. The letter stated that the rate increase would result in “draconian cuts for imaging services.”

The utilization rate assumption, which the Medicare reimbursement formula for imaging procedures is based on, is “the amount of time that imaging equipment operates during the hours a physician's office is open for business,” according to a MITA release. CMS recently proposed that the utilization rate should be raised from 50% to 90% for equipment that costs more than $1 million. Additionally, President Obama recommended a 95% rate for advanced imaging equipment.

Both MITA and medical technology industry group AdvaMed have criticized the foundation for the proposed rate increases. They say that the Medicare Payments Advisory Commission (MedPAC) recommendation that shaped these suggested rates is flawed.

“The MedPAC recommendation to reduce imaging payments is not based on rigorous analytic finding,” said president and CEO of AdvaMed Stephen J. Ubl in a written statement. The survey MedPAC conducted on imaging equipment had a low response rate, lacked geographical representation in the sample section, and focused on only two imaging modalities (MR and CT equipment), Ubl said.

Echoing AdvaMed's concern, MITA says that the proposed increases fail to take into account the lower rate of use in rural areas. Due to this geographical disparity, Ilyse Schuman, managing director of MITA, says that it is difficult to create an accurate nationwide sample to base the rate on. She worries that, if enacted, the rates would prevent patients in rural areas from accessing imaging technologies.

Schuman says that a better alternative is to rely on physician-developed appropriateness criteria (see sidebar on p. 20). By performing “the right scan at the right time,” imaging costs could be reduced “without harming access to patient care,” she said.

Establishing a nationwide diagnostic imaging exchange network (DIEN) is another potential cost-cutting measure that MITA supports. The network would allow doctors to access past scans of patients, thus eliminating many duplicative procedures, the industry group says.

If the recommended rates are implemented, patients wouldn't be the only group affected. The change in reimbursement policy could also stifle innovation among medical equipment manufacturers, Schuman says. The increased rates would make it more difficult for providers to invest in new imaging technologies.

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