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  • 02.3.15

    AMIC Says White House 2016 Budget Threatens Patient Access to Medical Imaging

    Coalition Urges Administration to Maintain Two Separate Fee Schedules for Medicare Reimbursement for Outpatient Imaging Services and Advocates against Prior Authorization for Medical Imaging Services

    Washington, D.C. – The Access to Medical Imaging Coalition (AMIC) today expressed concern that President Obama’s proposed 2016 budget would harm patient access to medical imaging services by implementing a prior authorization system for advanced medical imaging and establishing “site-neutral” payments for Medicare reimbursement for all services performed in offsite hospital outpatient departments, including imaging. The current Medicare payment systems maintain two separate fee schedules for hospital outpatient services and physician office services because providing care in an integrated hospital system is different than in the physician office.

    “President Obama’s budget threatens patient access to care and important imaging services by ignoring the stark differences in patient populations and scope of services provided across sites, and by instituting an unnecessary administrative barrier between patients and their physicians,” said Tim Trysla, executive director of AMIC. “Medicare should maintain separate fee schedules due to the unique combination of services provided by hospitals as compared to physician offices. Hospital outpatient departments, both on and off of a main hospital campus, play a critical role in advancing coordination of care for Medicare beneficiaries. Leveling payment rates for off-campus hospital outpatient centers down to physician office payment levels would undermine efforts to integrate services across the continuum of care.”

    “In addition, prior authorization requirements would impose huge administrative burdens on providers and the Medicare program, all while causing delayed or denied care.  There is no conclusive evidence showing that prior authorization of advanced imaging services improves ordering patterns or yields long-term savings,” said Trysla. “Rather, Congress and the Obama Administration should continue to work with AMIC to properly implement provisions enacted through the Protecting Access to Medicare Act which incentivizes widespread adoption of Appropriate Use Criteria (AUC) to ensure the proper use of medical imaging.”

    AMIC encourages the Obama Administration to work with patients and physicians toward policies that promote the appropriate use of medical imaging so that patients can benefit from the right scan at the right time.

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