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SNM takes action to alter DRA provision for imaging payment caps

RESTON, Va. -- As a member of the Access to Medical Imaging Coalition, SNM joined 75,000 physicians in asking Congress to reconsider the deep cuts made in medical imaging services for Medicare beneficiaries as part of the federal Deficit Reduction Omnibus Reconciliation Act of 2005. SNM, an international scientific and professional organization of more than 16,000 physician, technologist and scientist members, opposes a provision in the actpayment caps to physicians offices with imaging equipmentthat is set to begin Jan. 1, 2007.

The proposed reductions for diagnostic imaging reimbursement fail to recognize the fundamental differences between the costs associated with providing imaging services in a physicians office as opposed to a hospital outpatient department, said SNM President Martin P. Sandler. The final Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System rules, released earlier this month, give a true sense of the severity of the cuts that will affect our members. SNM opposes this legislation and is working as a member of AMIC to reverse or halt this implementation until the full impact of the cuts can be determined, he indicated.

Under DRA, reimbursement for Medicare beneficiaries who use outpatient imaging services at centers not affiliated with hospitals will be linked to HOPPS rather than MPFS in instances where the payment rate for the technical component of the PFS is greater than that of the HOPPS rate. The MPFS was developed to reflect the cost of imaging services based on factors that are specific for freestanding diagnostic imaging facilities (for example, separate payment codes and rates, overhead costs, staffing and equipment maintenance). These caps will apply to molecular and nuclear imagingincluding PET and PET/CT, X-rays, magnetic resonance imaging, computed tomography and fluoroscopy, said Sandler, explaining that imaging providers could be forced out of business or to limit their service
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Contact: Maryann Verrillo
mverrillo@snm.org
703-652-6773
Society of Nuclear Medicine
28-Nov-2006


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