US Government To Decide On Payments To Doctors Who Use Medical Imaging
October 29 2009 - 6:08PM
Dow Jones News
The U.S. federal government is expected to decide, as soon as
Friday, if it will slash payments to physicians who use
medical-imaging machines to screen patients for diseases like
cancer and heart problems.
The decision will likely stir controversy, because the
government has proposed cutting by up to 38% the amount it pays the
roughly one million doctors who participate in Medicare when they
use disease-screening equipment for procedures like MRIs and CT
scans. The move could also have implications for makers of this
equipment, including General Electric Co. (GE), Siemens AG (SI) and
Eastman Kodak Co. (EK).
The Centers for Medicare and Medicaid Services, or CMS, in July
proposed trimming the payments for doctors who use the equipment
because of concerns they were being overused and driving up
health-care costs. Health-care legislation in Congress would also
reduce payments for physicians using the machines, and President
Barack Obama has weighed in, saying the equipment is adding to the
burgeoning health-care tab.
The proposed rule would affect doctors and health professionals
who are paid under the Medicare Physician Fee Schedule and also
would result in cutting payments for radiation oncology procedures.
A broad coalition of congressmen, doctors and patient-advocacy
groups have decried such a move, saying the radiology equipment is
necessary to treat patients who already are shown to have
cancer.
Analysts expect the payment rates for the radiation oncology
procedures to remain unchanged. That would benefit companies such
as Varian Medical Systems Inc. (VAR) and Accuray Inc. (ARAY),
according to Washington Analysis, a research firm.
Tim Trysla, executive director of the Access to Medical Imaging
Coalition, an advocacy group representing physicians and patient
groups, said the proposed changes by CMS would be "seismic." The
coalition also includes companies that make the screening
equipment.
The proposal would increase the assumed rate at which diagnostic
machines are used to 90% from 50%. A higher assumed rate results in
lower payments.
Trysla, who is also a lawyer with the firm Alston & Byrd,
said CMS is basing its assumed rate on old data. He said the use of
MRI machines and others has dropped in the last several years.
He said that rather than "across-the-board cuts," the government
should focus on getting doctors to follow guidelines for when to
use the screening machines.
-By Jared A. Favole, Dow Jones Newswires; 202-862-9207;
jared.favole@dowjones.com