Well we have dodged the first bullet, but there is still a whole war to be won concerning H.R. 3630, known as theMiddle Class Tax relief and Job Creation Act that was passed on December 13th by the U.S. House of Representatives.  The Act prevents a further 27% cut to Medicare physician reimbursement and provides physicians with a 1% increase in Medicare payments for 2012 and 2013. So far, there have been no additional medical imaging cuts, so kiss your babies but keep your fingers crossed folks, because we still have to make it through to the Senate.

There is still the concern that this act does not contain information from the Diagnostic Imaging Services Access Protection Act (H.R. 3269), which protects against the implementation of a 25% payment reduction on professional fees for multiple MRI, CT and ultrasound procedures.  Fortunately, there are 127 supporters of H.R. 3269 in the House of Representatives and the ACR has announced that they will continue on their plight to add the language from H.R. 3269 as the SGR legislation heads to the Senate.

This SGR adjustment means good things but since it still does not address the proposed rule from CMS that would severely cut the Medicare reimbursement rate for radiologists who interpret multiple images, we have to hope that pressure from all concerned, including the ACR, pushes the Bill through. Although this is certainly a step in the right direction, this could just be a “quick fix” and the proposed cuts to radiologists would be the 8th cut in the past six years to Medicare funding for Diagnostic Imaging.  The seven cuts that have occurred over these past six years have totaled more than $5 Billion and with imaging growth at less than 2% annually, additional cuts would end up limiting American’s access to quality diagnostic imaging due to the facilities that would suffer and end up closing their doors if the cuts went through. Republican representative James Renacci did introduce a legislation that would allow for a six-month grace period for new diagnostic imaging centers, so that those certain suppliers of Medicare imaging services could bypass the MIPPA accreditation requirement to receive reimbursements during that period of time.  The grace period begins when a new physician or facility submits images to the accreditation process and ends either with the approval or denial of their request, or after 6 months have commenced.  The center will be able to receive reimbursements during this time, however if they are unable to get accredited by the end of the period, any reimbursements they received would need to be paid back.

It can be assumed that due to the Senate’s Democratic leadership, they will attempt to create their own version of the legislation that will include a one to two year “doc fix,” which equates to questionable Senate action timing.  TheRBMA estimates that a package will be put together by the end of the week and voting will take place Monday or Tuesday, dependent upon the ability to create a package that gains some Republican Senate support.  This brings a whole new meaning to the term, a house divided sports fans, and we could end up waiting on a decision until well into 2012.

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