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  • 11.3.11

    Access To Medical Imaging Coalition And 21 Groups Call On Congress To Oppose RBMS And Payment Cuts To Medical Imaging Services For Seniors

    Washington D.C. – The Access to Medical Imaging Coalition (AMIC), together with 21 patient advocacy and professional organizations, today urged Congress not to adopt a prior authorization policy and further reimbursement cuts for medical imaging services, stating that both policy changes would negatively impact the delivery of life-saving care to nearly 48 million Medicare beneficiaries.

    “We are concerned that additional reimbursement cuts and proposals such as prior authorization will result in reduced access and longer wait times for our seniors and greater administrative burdens on our physicians,” said Tim Trysla, executive director for AMIC. “Patients and providers have joined together to ensure that Congress understands the risks of further reducing Medicare payments for life-saving diagnostic imaging services and using RBMs, which have never been proven effective, to deny imaging services.  This is a groundswell that Congress can’t ignore.”

    In a letter to the chairmen and ranking members of the committees with jurisdiction over federal health care programs, the chairs of the Joint Select Committee on Deficit Reduction, and House and Senate leadership, AMIC and the 21 patient advocacy and professional organizations expressed concern about the prior authorization and reimbursement policies under consideration:

    • Prior authorization, or radiology benefit managers (RBMs), in Medicare would directly block patient access to care and impose huge administrative burdens on providers and the Medicare program while never having been proven effective through independent research.
    • Further reducing Medicare payments will continue to reduce access to imaging services in the community as centers and physician practices consolidate or close, leading to long wait times for an appointment and longer driving distances to the nearest imaging center or hospital.

    Since the Deficit Reduction Act of 2005, Medicare payments for medical imaging services have been reduced repeatedly, with some cuts yet to be fully implemented. By 2013, many key services will have been cut by more than half.  For example, an MRI of the brain will have been cut by 60.7 percent by 2013. Payments for even a simple chest x-ray will have been cut nearly 25 percent by 2013.

    “The most recent Medicare claims data show that imaging spending and utilization are flat and suggest access problems for important services like mammography and bone density scans,” Trysla continued. “Additional cuts to imaging reimbursement and an unprecedented and unproven prior authorization program would only further impede beneficiaries’ access to care.”

    A recent literature review by The Moran Company of prior authorization as a method of controlling imaging utilization found no independent validation of the effectiveness of RBMs and revealed that a prior authorization program in Medicare would be unlikely to yield any budgetary savings.

    The letter was signed by the Access to Medical Imaging Coalition (AMIC), American Brain Tumor Association, American College of Nuclear Medicine, American Pain Foundation, Association of University Radiologists, Bladder Cancer Advocacy Network, Coalition for Pulmonary Fibrosis, Colon Cancer Alliance, COLONTOWN, Community Oncology Alliance, Hypertrophic Cardiomyopathy Association, Lung Cancer Alliance, Patient Advocates for Advanced Cancer Treatments, Radiological Society of North America, Society of Chairs of Academic Radiology, Sarcoma Foundation of America, Society of Interventional Radiology, Society for Nuclear Medicine, Sudden Cardiac Arrest Association, Us TOO International Prostate Cancer Education & Support Network, YES! Beat Liver Tumors and ZERO: The Project to End Prostate Cancer.

    The full letter can be found here.

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    The Access to Medical Imaging Coalition represents more than 100,000 physicians, medical providers, and patient organizations throughout the U.S. It also includes health technology firms that manufacture imaging equipment and supplies and that employ tens of thousands of workers. Thus, AMIC represents those who develop medical imaging technologies, those who apply it, and those who benefit from it.

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