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White House Again Looks To Imaging Cuts To Help Raise Health Reform Funds

This article was originally published in The Gray Sheet

Executive Summary

For the second time this year, medical imaging made it on to President Obama's list of targeted Medicare cuts that could help pay for comprehensive health reform

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Reimbursement For Imaging Remains In Flux In Proposed Fee Schedule

Diagnostic imaging payments continue to be a focus of Medicare doctor payment policies in CMS' 2011 physician fee schedule 1proposal, issued June 25

Reimbursement For Imaging Remains In Flux In Proposed Fee Schedule

Diagnostic imaging payments continue to be a focus of Medicare doctor payment policies in CMS' 2011 physician fee schedule 1proposal, issued June 25

Medicare imaging savings

Obama administration estimates that increasing the imaging equipment utilization factor used by CMS to calculate payments would save $2.5 billion over five years and $5.9 billion over 10 years in a "mid-session" 1review of the president's budget released last week. In June, as part of a plan to help pay for health reform, the administration floated the idea of changing the assumed equipment use rate from the current 50% to 95% of the time that imaging facilities are open, but did not quote specific savings figures (2"The Gray Sheet" June 22, 2009). Equipment manufacturers and radiologists have railed against the proposal, asserting that it would lead to significant underpayment for advanced imaging and harm rural clinics disproportionately. The mid-session review also shaves $10 million off the projected 10-year savings from implementation of a prior authorization requirement for Medicare-covered imaging scans - another proposal in Obama's health reform reserve fund (3"The Gray Sheet" March 2, 2009)

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