Dave Fisher

Over the last several years, the medical imaging community has experienced a number of government-enforced reimbursement cuts. Most recently, the Medicare Payment Advisory Commission (MedPAC) has announced medical imaging cuts. In addition, versions of several trade bills have proposed raising the current utilization rate for molecular imaging—which would mean reduced reimbursement—in support of the unrelated Trade Adjustment Assistance (TAA) program.

“There are three free trade agreements (South Korea, Colombia, and Panama), and those agreements were negotiated by the Bush administration,” said Dave Fisher, executive director of the Medical Imaging & Technology Alliance (MITA). “There have been ongoing discussions about them and a lot of controversy about attaching a fourth bill called the TAA, which would provide assistance to workers.

“That’s the package of legislation. Within the TAA bill—that bill costs a little bit of money because it provides some assistance—there was an offset that would have affected imaging utilization rates. The version of the bill that was released on Thursday [June 30] no longer included that offset.”

Despite the recent proposal of the bill not including the TAA offset, Fisher cautions that the medical imaging community is not out of the woods yet. All of these proposals are simply markups of what the final bill, to be determined by President Obama, may look like. Fisher compares these proposals to recommendations as to how the final bill should look, rather than proposed bills.

Why the medical imaging community has been continually targeted and affected by these and similar cuts is more pressing. Fisher believes that much of the current legislation is being based on outdated information concerning the medical imaging community.

“People still believe imaging is growing based on data from 10 years ago when in fact it’s not true anymore,” said Fisher. “Since 2006 when we first started enduring the cuts in reimbursement, there has been a sea change in the utilization rate.

“It’s actually something that’s a bit frustrating from my perspective because as recently as March, MedPAC stated that imaging utilization was flat. Spending on imaging is down from 2006. We’ve been hit by five separate reductions, whether it’s through reimbursement reductions, through legislation, or through administrative action in the last 5 years. And frankly, I feel like without all of these cuts even being put in place yet, it’s completely inappropriate and harmful to patients to continue to enact these cuts.”

Fisher warns that utilization rates—one factor in an algorithm that determines reimbursement—are increasing to a point that no longer supports local imaging centers, which could have a serious effect on the patient population. In addition, with lower reimbursement rates comes less capital for imaging centers to spend updating equipment, restricting the patients’ access to the newest technology.

But invested associations like MITA are not taking these cuts sitting down. These associations will continue to reach out to lawmakers and their local communities to fight against these seemingly persistent medical imaging cuts.

“We’re going to continue to work with our partners in the community as well as patient groups to help educate folks on the Hill as well as educate the administration, to make sure that accurate information is being shared with policymakers and that all of them understand that imaging is not a high growth industry right now,” said Fisher. “Additional cuts will have major implications on the future.”