Feature | July 16, 2012

ACC, ACR Scorn Proposed Medicare Physician Fee Schedule

July 16, 2012 — The American College of Cardiology (ACC) and the American College of Radiology (ACR) are warning that the extreme cuts to funding for medical imaging scans in the 2013 Medicare Physician Fee Schedule Proposed Rule are unnecessary, unfounded and will undermine patient care.

The proposed rule calls for an expansion of the multiple procedure payment reductions for interpretation of scans performed on the same patient, in the same session on the same day, to all providers in the same practice or hospital. The Centers for Medicare and Medicaid (CMS) expanded both the number of physicians affected by this policy and the number of exams. ACR issued a statement explaining there is no publicly available evidence to support a 25 percent reduction to physician interpretation payments in general. A 2011 study proves that any efficiencies in the multiple procedure setting are highly variable and, at most, total one-fifth of what CMS contends. No efficiencies in care support a funding cut when different physicians in a group practice interpret separate imaging scans for the same patient, ACR stated.

“The proposed Medicare physician fee schedule rule undeniably has negative consequences for physicians and their patients," said ACC President William Zoghbi, M.D., FACC. "In addition to the mandated 27 percent sustainable growth rate (SGR) cut, CMS proposes an additional 3 percent reduction for cardiovascular services.

“Part of these cuts result from a misguided policy that will reduce payment if more than one diagnostic cardiovascular service is provided on the same day. This policy disadvantages physicians who aim for efficiency and reduces payments based on a misguided understanding of how different services, such as echocardiography and SPECT imaging, are from one another.  Furthermore, it would lead to a major inconvenience to patients. We aim to demonstrate to CMS why this proposal would not be beneficial.   

“Congress has until the end of 2013 to come up with a solution to the flawed SGR payment formula and to prevent next year’s SGR-based cut, currently estimated at 27 percent, from taking effect. The need to fix SGR continues to be a top priority in the United States.

“With the Accountable Care Act (ACA) ruling behind us, it's time to continue down the path to healthcare reform. The American College of Cardiology’s goal is a sustainable system that rewards quality and focuses on patient-centered care.  While this rule takes steps in that direction, it is undermined by old ways of cutting payments without improving quality.”

The ACR also issued a strongly worded statement about the cuts.

“These cuts affect primarily those suffering from multiple trauma or heart attacks, stroke patients and those with widespread cancer — all of whom often require multiple imaging scans to survive," said Paul Ellenbogen, M.D., FACR, chair of the American College of Radiology Board of Chancellors. "Interpretation of these scans often requires expertise of different physicians. These are not screening exams for otherwise healthy people. They are for people with immediately life-threatening illnesses or injuries. These cuts discourage doctors from working as a team and pull the rug out from under the very physicians working to save these people’s lives."

For more information: www.cardiosource.org/ACC

Related Content

Amazon, Berkshire Hathaway and JPMorgan Chase to Form New Healthcare Company
News | Business | January 30, 2018
January 30, 2018 — Amazon , Berkshire Hathaway and JPMorgan Chase & Co.
News | Business | January 16, 2018
American College of Cardiology (ACC) Chief Executive Officer Shalom “Shal” Jacobovitz will be leaving the College...
CMS Launches New Voluntary Bundled Payments Model
News | Business | January 10, 2018
The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (Innovation Center)...
Toshiba Medical Systems Changes Name to Canon Medical Systems Corp.
News | Business | January 08, 2018
January 8, 2018 — Canon Inc. and Canon Medical Systems Corp.
CMS Announces Final Changes, Cancellations of Mandatory Bundled Payment Models
News | Business | December 21, 2017
The Centers for Medicare & Medicaid Services (CMS) last week finalized the cancellation of the mandatory hip...
Catheter reprocessing can reduce costs in the cath and EP lab.
Feature | Business | December 19, 2017 | Lars Thording
As payers and other healthcare entities look to better manage costs, especially in the acute care setting, it is impo
FDA Issues Final Guidance on Investigational Device Exemption Categorization
News | Business | December 19, 2017
The U.S. Food and Drug Administration (FDA) recently issued a final guidance, “FDA Categorization of Investigational...
Congressional Budget Office Finds cutting ACA insurance mandate will cause 13 million people to become uninsured, higher insurance premiums. American Heart Association (AHA), #AHA2017
News | Business | December 06, 2017
December 6, 2017 — At the American Heart Association (AHA) annual meeting in November, a group of 16 non-partisan pat
5 Tips for Medical Device Engineers on FDA Design Controls
Feature | Business | November 24, 2017 | Jon Speer
If you are an engineer in the medical device industry, you probably have a love/hate relationship with the FDA-mandat
Videos | Business | November 09, 2017
A discussion with Peter L.
Overlay Init