News | Business | December 22, 2015

ACR Applauds House for Passing MPPR Rollback, Mammography Protections

If approved by Senate and signed into law, measures would lower imaging reimbursement reductions by 80 percent, delay USPSTF breast screening recommendations for two years

ACR, House, PALS Act, Consolidated Appropriations Act, mammography, MPPR rollback

December 22, 2015 — The American College of Radiology (ACR) applauded the U.S. House of Representatives for including access to imaging care protections for the most sick and injured Medicare beneficiaries and women seeking mammograms in the House-passed Consolidated Appropriations Act.

“The ACR, its member physicians, patients and others have worked with Congress to improve and safeguard patient access to vital imaging care through the protections in this bill. The access to care that these steps will allow can literally mean the difference between life and death for many Americans. We urge the Senate to pass the bill and the President to sign it into law with all haste,” said Bibb Allen, Jr., M.D., FACR, chair of the American College of Radiology Board of Chancellors.

Thanks to a movement spearheaded by the ACR, the bill includes an 80 percent roll-back (from 25 percent to 5 percent) of a Multiple Procedure Payment Reduction (MPPR) to Medicare reimbursement for interpretation of advanced imaging scans performed on the same patient in the same session, on the same day. In recent years, the Centers for Medicare & Medicaid Services (CMS) applied a 25 percent MPPR to the professional component of these services. Beginning Jan. 1, 2017, the bill caps any reduction at 5 percent. This is more in line with peer-reviewed research that shows that any efficiencies gained in that scenario are variable and, at most, a fraction of what CMS contends, but has never produced documentation to support. In fact, the ACR said that CMS consistently ignored a statutory mandate in the Protecting Access to Medicare Act of 2014 requiring the agency to publicly disclose the data it used to justify what the association calls flawed funding cut.

“This MPPR rollback eases the impact on access to needed imaging care for auto accident and stroke victims, those with widespread cancer, and others who often require interpretations by different doctors to recover. Physicians and lawmakers worked together to ensure adequately-covered access to this lifesaving care. Patients and providers will benefit from this, once the bill is passed by the Senate and signed into law and implemented by CMS,” said Geraldine McGinty, M.D., MBA, chair of the American College of Radiology Economics Commission.

ACR-backed Protecting Access to Lifesaving Screenings Act (PALS Act) language included in the bill will continue mandatory mammography insurance coverage for millions of women nationwide. The PALS Act provision delays implementation of U.S. Preventive Services Task Force (USPSTF) draft breast cancer screening recommendations for two years.

The Affordable Care Act (ACA) requires private insurers to cover exams or procedures given a grade of “B” or higher by the USPSTF. The Task Force gave routine screening of women ages 40–49 a grade of “C” and gave a “B” grade only to biennial (every other year) screening for women 50–74. This would indicate that women ages 40–49 who choose routine screening and those 50–74 who want to be screened annually would not be guaranteed coverage if these draft recommendations were implemented. This would particularly impact women in underserved and rural areas.

“The protections in this legislation allow women ages 40-and-over who choose to get an annual screening mammogram to be covered, with no copay, for these lifesaving exams. The bill also allows time for breast cancer experts to properly vet the USPSTF recommendations and the process by which they were created as well as more recent literature on mammography screening. This will help ensure sensible screening policy that saves the most lives and minimizes any viable screening concerns” said Debra Monticciolo, M.D., FACR, chair of the American College of Radiology Breast Imaging Commission.

For more information: www.acr.org

Related Content

Sponsored Content | Videos | 3-D Printing | November 17, 2017
Dee Dee Wang, M.D., Director, Structural Heart Imaging at Henry Ford Hospital, Detroit, explains how her center uses
Keith Dreyer, DO, said artificial intelligence is one of the most important developments to watch in radiology at the opening session of RSNA 2016.

Keith Dreyer, DO,  said artificial intelligence is one of the most important developments to watch in radiology at the opening session of RSNA 2016.

Feature | Artificial Intelligence | November 17, 2017
November 16, 2017 — The American College of Radiology Data Science Institute (DSI) will provide the framework, strate
Carestream Begins Shipping MyVue Center Self-Service Kiosk in Select Countries
News | PACS Accessories | November 16, 2017
Carestream Health began shipping its MyVue Center Self-Service Kiosk that can enhance patients’ ability to access and...
Siemens Healthineers Signs Service Agreement With WhidbeyHealth Community Health System
News | Population Health | November 14, 2017
November 14, 2017 — Siemens Healthineers and WhidbeyHealth of Washington State have signed a ten-year, enterprise-wid
Biop Medical Launches Cervical Cancer Diagnosis Technology at MEDICA 2017

Biop Medical cervical cancer detection system

Technology | Women's Health | November 13, 2017
November 13, 2017 — Biop Medical announced it will present its point-of-care...
Upcoming radiology conferences, meetings and events.
News | November 13, 2017
ITN maintains a comprehensive listing of radiology specialty meetings on its website at ...
Kansas City Radiology Center Employs iCAD PowerLook Tomo Detection for DBT
News | Computer-Aided Detection Software | November 10, 2017
November 10, 2017 — Imaging for Women, a leading radiology center in Kansas City, Mo., announced it is now using iCAD
Kubtec Brings Image Analytics Capabilities to Tomosynthesis Specimen Imaging Systems
News | Mammography | November 10, 2017
Kubtec announced it will be showcasing new image analytics capabilities on its advanced tomosynthesis specimen imaging...
Siemens Healthineers Introduces Share360 Tailored Service Portfolio
News | Imaging | November 10, 2017
November 10, 2017 — To address the specific needs of...
Johns Hopkins Researchers, Carestream Give Presentations on Medical Imaging Advances at RSNA
News | Digital Radiography (DR) | November 09, 2017
November 9, 2017 — Researchers from The Johns Hopkins University School of Medicine and Carestream Health scientists
Overlay Init