MedPAC Urged to Reconsider Imaging Reimbursement Cuts

John Commins, for HealthLeaders Media , June 17, 2011

Nine patients' advocacy groups cosigned the letter with AMIC, including It's My Heart, Colon Cancer Alliance, and Kidney Cancer Association.

Tim Trysla, executive director of AMIC, said in a media release that patients affected by cancers, heart disease, and other illnesses need to be made aware of the potential impact of the MedPAC recommendations.

"Even though MedPAC has acknowledged that the most recent Medicare claims data show that advanced imaging spending and volume are flat, they are recommending further cuts to imaging reimbursement and an unprecedented prior authorization program that would, by definition, impede beneficiaries' access to care," Trysla said.  
Trysla said there is no scientific research validating the clinical quality of radiology benefit managers or whether they truly achieve cost savings or merely shift costs. He said there are numerous peer-reviewed articles supporting the use of advanced imaging studies. "RBMs are not accountable or transparent to the public, and their proprietary algorithms deny or delay care without any peer-reviewed clinical evidence showing they are safe," he said.

John Commins is a senior editor with HealthLeaders Media.

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