Physicians are balking over a proposal to curb the overuse of MRIs and other advanced imaging in Medicare, according to a Kaiser Health News report.
The recommendation, which is expected from a congressional advisory group on June 15, would require some physicians and their patients to receive pre-approval from Medicare for advanced imaging services. The proposal would only apply to physicians who have historically shown high rates of inappropriate imaging use.
According to Robert Berenson, vice chairman of the Medicare Payment Advisory Commission, the proposal is intended to curb "bad behavior" of physicians who buy imaging equipment and use it to generate unnecessary services. Of all the physicians who order advanced imaging, 10 percent of physicians are responsible for half of all procedures.
The proposal also aims to reduce Medicare imaging costs, which have jumped from $6.5-$11.7 billion between 2000 and 2009, according to the report. While industry groups say use of imaging services declined from 2008-2009, MedPAC counters that usage is rising.
The proposal has met opposition from physician groups and medical imaging companies, according to the report. A March letter from two dozen physician groups to MedPAC Chairman Glenn Hackbarth said Medicare payments for diagnostic imaging services in non-hospital settings have been subject to significant cuts in recent years, and payment reductions should not be imposed until current cuts have been fully implemented.
Read the Kaiser Health News report on Medicare imaging.
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The recommendation, which is expected from a congressional advisory group on June 15, would require some physicians and their patients to receive pre-approval from Medicare for advanced imaging services. The proposal would only apply to physicians who have historically shown high rates of inappropriate imaging use.
According to Robert Berenson, vice chairman of the Medicare Payment Advisory Commission, the proposal is intended to curb "bad behavior" of physicians who buy imaging equipment and use it to generate unnecessary services. Of all the physicians who order advanced imaging, 10 percent of physicians are responsible for half of all procedures.
The proposal also aims to reduce Medicare imaging costs, which have jumped from $6.5-$11.7 billion between 2000 and 2009, according to the report. While industry groups say use of imaging services declined from 2008-2009, MedPAC counters that usage is rising.
The proposal has met opposition from physician groups and medical imaging companies, according to the report. A March letter from two dozen physician groups to MedPAC Chairman Glenn Hackbarth said Medicare payments for diagnostic imaging services in non-hospital settings have been subject to significant cuts in recent years, and payment reductions should not be imposed until current cuts have been fully implemented.
Read the Kaiser Health News report on Medicare imaging.
Related Articles on Coding, Billing and Collections:
Coding Inaccuracies That May Put Orthopedic Spine and Pain Management-Driven ASCs at Risk With the OIG and RACs
AAPC: Append Modifier 22 to Unusually Difficult Procedures
CMS Issues Hints for Crosswalking ICD-9/ICD-10 Codes