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MITA says IPPS final rule will establish flawed payment models, jeopardize patient access to medical imaging technologies

The & Technology Alliance () have said that the Centers for Medicare & Medicaid Services’ (CMS) hospital inpatient prospective payment system (IPPS) final rule will jeopardize patient access to computed tomography (CT) and (MR) services by instituting inaccurate payment models.

“This policy is will result in further cuts to reimbursement for life-saving medical imaging technologies,” said , executive director of MITA. “Separate cost centers for capital equipment such as CT and MR require valid data inputs in order to arrive at appropriate payments. The payments that result from this policy lack face validity and will result in absurd reimbursement levels for which CMS would pay hospitals nearly the same rate for advanced CT as it would for X-ray.

CT and MRI services are capital intensive and allocation of capital costs within the cost reports is both complicated and subject to error. The new CT and MR cost centers will result in payment rates that do not reflect the differences in diagnostic power between imaging tests, as well as a hospital’s investment in advanced imaging technology.

“It is troubling to know that these nearly double-digit cuts to reimbursement will threaten patient access to recent advances like CT radiation dose reduction,” Rodriguez continued. “Patients shouldn’t be denied access to medical innovations simply because CMS is trying to make a point about their preferred hospital accounting methods.”

CMS is currently proposing to use the same flawed cost model to determine hospital outpatient payments. CMS’ own analyses indicate that when applied to the outpatient setting, this policy results in payment drops as large as 38 percent for CT and 19 percent for MR. Furthermore, in the IPPS final rule, CMS acknowledges “significant payment impacts” as an effect of this policy with Deficit Reduction Act caps on the Physicians Fee Schedule payments.

“We are concerned that CMS will extend this same policy to the hospital outpatient department which will have detrimental impacts for CT and MR reimbursement in that setting as well as in the non-hospital setting,” Rodriguez added. “This policy is a disservice to patients whose health outcomes are dependent on access to CT and MR imaging.”

Source

The Medical Imaging & Technology Alliance (MITA)