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New taxes in health care legislation may affect imaging centers
Proposed reforms targeting diagnostic imaging tests could affect their future delivery and use.
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New excise taxes, coupled with cuts to Medicare reimbursement, could force some hospitals to cut back on imaging tests used for the early detection of heart disease and cancer.
Patients with heart disease and cancer, survivors of CVD and cancer illnesses, patient advocacy groups and physicians gathered for a rally last month to urge Congressional leaders to help preserve access to advanced imaging technologies. The inclusion of more than $40 billion in a new excise tax on medical devices (including imaging equipment) as part of new health care legislation, coupled with scheduled cuts in Medicare reimbursement and changes to the Medicare Physician Fee Schedule, has some people worried that service will be scaled back as a result.
The changes to Medicare reimbursement for imaging procedures center on alteration of the utilization assumption. President Barack Obama has recommended that the Centers for Medicare and Medicaid Services recalibrate the reimbursement formula to raise the utilization assumption from CMS’s current level of 50% to 95% for advanced imaging equipment. Legislation in the House of Representatives would change the current utilization assumption to 75%. Data from the Radiological Business Management Association suggested that “neither rural nor urban nonhospital diagnostic imaging providers operate equipment at rates anywhere near [the proposed] levels.” Results from a survey cited in the press release suggested that imaging equipment is operating 48% of the time the office is open in rural areas and 56% of the time the office is open in nonrural areas.
Additional changes proposed by CMS will affect the Medicare Physician Fee Schedule by cutting the technical component of diagnostic imaging services. According to the press release, the proposed cuts combined with currently implemented cuts and adjustments in equipment utilization rates would represent a total cut of 60% during a five-year period.