Medicare proposes a 50% cut for some imaging fees in 2012

[The Straight Story]

Medicare proposes a 50% cut for some imaging fees in 2012

Washington -- As physicians try to stop an across-the-board Medicare pay cut of 29.5% from taking effect in January, the Centers for Medicare & Medicaid Services is proposing additional pay reductions for certain specialists and penalties for those who fail to prescribe electronically next year.

The proposed 2012 physician fee schedule released July 1 paints a gloomy picture for doctors participating in Medicare. CMS is required by statute to implement the across-the-board cut unless Congress steps in to prevent it. But the agency also would expand its multiple procedure payment reduction policy to physicians who interpret the results of certain advanced diagnostic imaging scans.

...

The proposal extends a multiple procedure policy that already has been applied to certain surgical and therapy services, and CMS might not stop there. The agency has said that money that is saved by reducing rates for overvalued services helps boost pay for primary care and other services that it considers undervalued.

The latest imaging cut proposal prompted a strong reaction from radiologists. Many CMS pay revisions are first approved by Congress or recommended by a rate review panel convened by the AMA, but not in this case.

http://www.ama-assn.org/amednews/2011/07/18/gvl10718.htm

[NashVegas]

1. $2k in Bio-Imaging Scans

for my ortho to say, "why yes, you're right, that IS a cyst" and "yes, that IS achilles tendonitis."

And you think they're not scamming Medicare?

[sinkingfeeling]

2. $3500 for a PET scan and another $500 to have it 'read'.

[asjr]

3. It is the "reading" part that gets my ire up.

[Booster]

4. There's so many ways to cut in Medicare. Just a small example:

I use a CPAP machine for my sleep apnea as do millions of old people do (young ones too). The machine would cost around $500 but Medicare "rents" it for $175 a month. If Medicare would negotiate with the suppliers to pay for the replacement parts as they wear out, I would gladly buy the damn machine. Think about how many different types of medical things Medicare rents. I'm talking about medical things like my machine that I WILL HAVE TO USE THE REST OF MY LIFE. That would add up to a lot of money.

[jwirr]

6. They rented my daughter a air mattress so she would not get bedsores.

We sent it back to them and bought another type with her personal spending money. I think the problem is that they do not realize that some people using this equipment are not going to die tomorrow.

[Booster]

7. And if they would have just bought you one you could have

deflated it and used it again if the problem ever reoccurred. Things like that are just dumb in my book.

[jwirr]

8. They once refuse a new arm pad for $22, 99 for her wheelchair we bought in

the 80s until I threatened to order a whole new wheelchair. The problem is that these bills go into the state or insurance company (Blue Cross) and the workers handling them are not professional medical workers. They do not know what they are talking about so they waste time and money in reviews. Besides Blue Cross threw all of their documents from Medicaid away when they took over the programs - they paid for the original chair but had no documentation. They were also stupid enough to argue with the doctor, foster family, home health care workers and me, the parent - insisting that she did not have a wheelchair. Under Pawlenty's watch you know.

[jwirr]

5. Oh, oh, it is small hospital that are going to get hurt on this. Many of them

have invested in these machines rather than send their patients to larger hospitals. Also patients - they may not get the tests they need. Also if they doctors will not serve the elderly and the disabled - their paycheck is going to go down.

When are the professional middle class going to learn that they are the target as much as the poor?

[Igel]

9. Small hospitals, but also some larger ones.

My mother goes to a medical complex that's affiliated with a fairly large hospital. Both serve primarily senior citizens and are located near Sun City in AZ.

A lot of the tests they schedule for her are simply unnecessary. They're ordered because the standard protocols say they should be ordered or there's some possibility that they might cover the doctor's ass; if they're not ordered and something goes wrong, the doctor could be found negligent. If they're ordered and as expected show nothing, no problem as long as there's some reason, however trivial, for ordering them.