News | April 18, 2013

Obama Administration 2014 Budget Would Restrict Self-Referral of Imaging, Radiation Therapy

Budget does not include reductions in reimbursement for advanced diagnostic imaging services

April 18, 2013 — The Obama administration has released the long-anticipated budget proposal for fiscal 2014. Although the document did not include specific reductions in reimbursement for advanced diagnostic imaging services, the fiscal 2014 budget would largely exclude certain imaging services from the in-office ancillary services exception (IOASE) to the Stark self-referral law and calls for prior authorization for advanced imaging services.

The fiscal 2014 budget recommends the exclusion of certain services, specifically advanced diagnostic imaging, radiation therapy and physical therapy, from the IOASE to the Stark self-referral law. This particular self-referral policy proposal, however, provides an exception "in cases where a practice meets certain accountability standards, as defined by the secretary." No further details are available at this time to further clarify this portion of the policy. According to documents recently released by the Office of Management and Budget, closure of this loophole is expected to save the government $2.14 billion over five years and $6.05 billion over 10 years.

While the Obama administration includes provisions supporting the imposition of third-party, prior authorization for the most expensive imaging services, the budget document essentially renders this concept meaningless by acknowledging that no savings can be generated from this policy. Favorable past recommendations from the Government Accountability Office as well as expanded use in the private sector are the primary reasons cited by President Obama in support of prior authorization services.

"First and foremost, the College is pleased that the Obama administration correctly recognized the need to avoid any further injurious reductions in imaging reimbursement within its latest budget proposal," said, Paul Ellenbogen, M.D., FACR, ACR chairman of the board of chancellors. "It is also truly gratifying to see that, after many years of persistent advocacy by ACR’s membership, leadership and staff, in concert with our colleagues at the Alliance for Integrity in Medicare (AIM), the Obama administration is finally recognizing the importance of stopping abuse of advanced diagnostic imaging services through the Stark self-referral loophole. Nevertheless, we recognize that the policies outlined in the fiscal year 2014 budget, especially those pertaining to self-referral, are not binding legislation and much more work is needed to be done before these changes are enacted into law."

For more information: www.acr.org

Related Content

Siemens Healthineers Announces First U.S. Install of Somatom go.Top CT
News | Computed Tomography (CT) | September 17, 2018
September 17, 2018 — The Ohio State University Wexner Medical Center in Columbus recently became the first healthcare
Key Patient Preparations for a CT Scan
News | Computed Tomography (CT) | September 05, 2018
The Center for Diagnostic Imaging (CDI) in Miami recently released a list of important preparations patients should...
Videos | Computed Tomography (CT) | July 25, 2018
A discussion with Patricia Dickson, LRT(CT), director of imaging and outpatient services, Capital Cardiology Associat
Videos | Computed Tomography (CT) | July 23, 2018
Ed Nicol, M.D., FSCCT, MBA, head of cardiac CT, Royal Brompton Hospital, London, and chair of the Society of Cardiova
Videos | Computed Tomography (CT) | July 17, 2018
An interview with Patrick Serruys, M.D., Ph.D., Imperial College London, principal investigator of the SYNTAX III Tri
Zebra Medical Vision Announces FDA 510(k) Clearance of Coronary Calcium Algorithm
Technology | Computed Tomography (CT) | July 12, 2018
Zebra Medical Vision has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its Coronary...
IAC Awards First CT Accreditation for a Mobile Stroke Unit
News | Computed Tomography (CT) | July 09, 2018
The Intersocietal Accreditation Commission (IAC) recently recognized the University of Tennessee Health Science Center...
FFR-CT may soon replace invasive angiography for coronary lesion assessment. #EuroPCR 

Anexample of a clinical case of CT-FFR, which can derive the FFR numbers for their entire coronary tree using a noninvasive CT scan.

Feature | Computed Tomography (CT) | May 29, 2018
May 29, 2018 — Results from the innovative SYNTAX III Revolution Trial [1] underline the effectiveness of evolving no
James Min Named Editor-in-Chief of Journal of Cardiovascular Computed Tomography
News | Computed Tomography (CT) | May 01, 2018
James K. Min, M.D., FSCCT, has been selected for a five-year term as the new editor-in-chief of the Journal of...
FDA Clears Siemens' Somatom go.All, go.Top CT Scanners
Technology | Computed Tomography (CT) | April 18, 2018
April 18, 2018 — The U.S.
Overlay Init