Diagnostic Imaging Services Access Protection Act of 2011

Madam President, I have introduced the Diagnostic Imaging Services Access Protection Act of 2012, joined by my colleague from Louisiana, Senator David Vitter. Our goal is to preserve Medicare beneficiaries' access to life-saving advanced diagnostic imaging services, such as magnetic resonance imaging, MRI, computed tomography, CT, and ultrasound.

Let me explain why this legislation is necessary. Medicare reimbursement for radiology services is based on two components: technical and professional. The technical component comprises the cost of equipment, nonphysician personnel, and medical supplies associated with the imaging process. The professional component is calculated by factoring in the radiologist's time, effort, and skill involved in interpreting images, rendering patient diagnoses, and reporting the findings in the patient's medical record. In recent years, the Centers for Medicare and Medicaid Services sought to control imaging growth by cutting reimbursement for the technical component--reducing payment for multiple imaging services administered by the same physician to the same patient during a single office visit. This policy is referred to as the multiple procedure payment reduction, or MPPR. It is designed to take into account the efficiencies achieved by doing same-day procedures on the same patient, and for the technical component of radiology, it makes sense.

However this year, CMS decided to apply the MPPR to the professional component as well. The 2012 fee schedule rule, which took effect on January 1, cut the professional component reimbursement for radiologists by 25 percent for additional images. This payment reduction ignores the realities of medical practice. It is not supported by sound data, nor was it developed with meaningful physician input. Because each imaging study produces its own set of images that require individual interpretation, radiologists are ethically and professionally obligated to expend the same amount of time and effort interpreting each one, regardless of the number of images, the section of the body being examined, or the date of service.

Further, because radiologists are referral-based physicians who rarely order the studies they interpret, MPPR is an ineffective tool to reduce inappropriate utilization. Beneficiaries receiving multiple imaging studies often represent the sickest and most complex cases. They may have advanced cancer or be recovering from a stroke, serious car accidents, multiple gunshot wounds, or other forms of deadly trauma.

Not only will CMS' flawed policy disproportionately affect the most vulnerable patients, it may also create incentives to shift services away from the private practice setting, where the physician fee schedule applies, to the more expensive hospital outpatient setting.

Our legislation will ensure that CMS does not arbitrarily undervalue the role of the radiologist within the health care delivery system. It would cancel the MPPR cut to the professional component of radiology services through the end of 2012 and prevent it from taking effect in future years, pending more comprehensive study of the matter. Specifically, the Secretary of Health and Human Services would be prohibited from taking this action unless the reduction is based on the data, analysis, and conclusions of an independent expert panel convened by the Institute of Medicine.

A similar bill, HR 3269, has been introduced in the House of Representatives and it enjoys the strong bipartisan support of more than 240 cosponsors. I urge my colleagues to support this bipartisan and budget-neutral approach to preserving patient access to community- based diagnostic imaging services.