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  • 06.15.11

    MEDPAC RECOMMENDATIONS THREATEN PATIENT ACCESS TO THE RIGHT SCAN AT THE RIGHT TIME

    MEDPAC RECOMMENDATIONS THREATEN PATIENT ACCESS TO THE RIGHT SCAN AT THE RIGHT TIME

    Washington, D.C. – The Access to Medical Imaging Coalition (AMIC) today said that despite acknowledging that advanced imaging services growth is flat, the Medicare Payment Advisory Commission’s (MedPAC) recommendations to reduce reimbursements for CT, MRI and PET services and impose prior authorization requirements will reduce patients’ access to life-saving diagnostic and therapeutic services.  AMIC called on Congress to reject the recommendations.

    “Patients affected by cancers, heart disease and other conditions for which an early diagnosis is critical to their health and survival should take notice that MedPAC is shutting the door on patients and the benefits of medical imaging,” said Tim Trysla, Executive Director of AMIC.  “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 there is no scientific research validating the clinical quality of radiology benefit managers (RBMs) or whether they truly achieve cost savings or merely shift costs, whereas 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,” said Trysla.

    AMIC and several patient advocacy groups recently wrote to MedPAC to oppose the recommendations. (Letter available here.)

    A recent study of Medicare claims data by The Moran Company indicates that cuts to medical imaging may already be disrupting seniors’ access to important advanced medical imaging procedures.  From 2008 to 2009, use of advanced medical imaging procedures fell by 0.1 percent, the first decrease in 11 years studied, including volume decreases of 1.2 percent in MRI services, 0.3 percent in screening mammography and 2.2 percent in bone density (DEXA) scans.

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