News | April 18, 2013

Obama Administration 2014 Budget Would Restrict Self-Referral of Imaging, Radiation Therapy

Budget does not include reductions in reimbursement for advanced diagnostic imaging services

April 18, 2013 — The Obama administration has released the long-anticipated budget proposal for fiscal 2014. Although the document did not include specific reductions in reimbursement for advanced diagnostic imaging services, the fiscal 2014 budget would largely exclude certain imaging services from the in-office ancillary services exception (IOASE) to the Stark self-referral law and calls for prior authorization for advanced imaging services.

The fiscal 2014 budget recommends the exclusion of certain services, specifically advanced diagnostic imaging, radiation therapy and physical therapy, from the IOASE to the Stark self-referral law. This particular self-referral policy proposal, however, provides an exception "in cases where a practice meets certain accountability standards, as defined by the secretary." No further details are available at this time to further clarify this portion of the policy. According to documents recently released by the Office of Management and Budget, closure of this loophole is expected to save the government $2.14 billion over five years and $6.05 billion over 10 years.

While the Obama administration includes provisions supporting the imposition of third-party, prior authorization for the most expensive imaging services, the budget document essentially renders this concept meaningless by acknowledging that no savings can be generated from this policy. Favorable past recommendations from the Government Accountability Office as well as expanded use in the private sector are the primary reasons cited by President Obama in support of prior authorization services.

"First and foremost, the College is pleased that the Obama administration correctly recognized the need to avoid any further injurious reductions in imaging reimbursement within its latest budget proposal," said, Paul Ellenbogen, M.D., FACR, ACR chairman of the board of chancellors. "It is also truly gratifying to see that, after many years of persistent advocacy by ACR’s membership, leadership and staff, in concert with our colleagues at the Alliance for Integrity in Medicare (AIM), the Obama administration is finally recognizing the importance of stopping abuse of advanced diagnostic imaging services through the Stark self-referral loophole. Nevertheless, we recognize that the policies outlined in the fiscal year 2014 budget, especially those pertaining to self-referral, are not binding legislation and much more work is needed to be done before these changes are enacted into law."

For more information: www.acr.org

Related Content

Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
Four Blue Cross Blue Shield Companies Issue Positive Medical Policies on HeartFlow FFRct Analysis
News | Computed Tomography (CT) | August 09, 2017
HeartFlow Inc. announced that four Blue Cross Blue Shield companies have each issued a positive medical policy for the...
The American Lung Association created LUNG FORCE, a national movement to defeat lung cancer
News | Lung Cancer | August 02, 2017
To raise public awareness of lung cancer—the leading cancer killer of men and women—the American Lung Association's...
GE’s DoseWatch is a digital informatics solution that automatically collects, monitors and reports on radiation dose indices for diagnostic imaging exams
News | Radiation Dose Management | July 31, 2017
GE Healthcare announced that it has licensed computed tomography (CT) organ dosimetry technology developed at Duke...
Contrast Media from Bayer, trends in contrast media and developments in contrast media
Feature | Contrast Media | July 28, 2017 | By Dave Fornell
Here are several updates in medical imaging ...
New York Hospital Finds Significant Cost Savings With Toshiba’s Aquilion One CT
News | Computed Tomography (CT) | July 25, 2017
In five years, Kaleida Health’s Stroke Care Center (SCC) at the Gates Vascular Institute in Buffalo, N.Y., has realized...
Samsung Introduces FDA-Cleared BodyTom Elite CT Scanner
Technology | Computed Tomography (CT) | July 24, 2017
Samsung announced U.S. Food and Drug Administration (FDA) approval of the BodyTom Elite, an upgraded version of its...
Sponsored Content | Videos | CT Angiography (CTA) | July 21, 2017
DAIC and ITN Editor Dave Fornell discusses some of the most innovative new computed tomography (CT) technology and tr
ACR Updates Radiation Oncology and Medical Physics Guidance With ASTRO and AAPM
News | Radiation Dose Management | July 19, 2017
July 19, 2017 — The American College of Radiology (ACR) recently collaborated with professional medical societies to
Sponsored Content | Videos | CT Angiography (CTA) | July 19, 2017
Matthew Budoff, M.D., FACC, professor of medicine, David Geffen School of Medicine at UCLA, endowed chair of preventi
Overlay Init