Capitol Hill Cheat Sheet 2015

Find out the big issues members raised with their representatives during ACR 2015.

 HillDayCheatSheet

May 2015

On Wednesday, ACR members head  to Capitol Hill to discuss issues at the intersection of patient care and legislation. Here’s a cheat sheet explaining what radiologists are paying attention to on Capitol Hill.

Pushing Back on the Multiple Procedure Payment Reduction (MPPR).

This policy imposes a 25 percent reduction in the professional component reimbursement when two or more procedures are performed for the same patient by the same physician during a single session. The ACR believes this policy reflects CMS’s lack of understanding of how medical imaging is practiced. It overestimates perceived efficiencies within the professional component, is not based on sound data, and was not developed with substantial physician input. A recent peer-reviewed study found great variation in efficiencies based on modality, none of which approach the current 25 percent reduction.

Congress enacted legislation in 2014 to require the HHS secretary to disclose the data used to create the MPPR. However, this information has yet to be shared. This is where the Diagnostic Imaging Services Access Protection Act (H.R. 2043/S. 1020) comes in. The legislation seeks to repeal the current MPPR and require CMS to use comprehensive, empirical data when implementing similar reimbursement cuts in the future. Members on Capitol Hill will work to gain support for this legislation among their members of congress .

Advocating for Transparency and Accountability from the U.S. Preventive Services Task Force (USPSTF).

The USPSTF makes recommendations about preventive health care services, including a variety of cancer screening procedures. If that acronym is sounding familiar, it’s probably because of the USPSTF’s 2009 final screening mammography recommendations, which the ACR has stridently opposed. The task force advises against regular mammography screening for women 40–49 years of age, recommends mammograms only every other year for women between 50 and 74, and stops all breast cancer screening in women over 74. Josh Cooper, senior director for ACR government relations, calls the mammography guidelines “the ultimate case study in why these recommendations need to be reformed.”

That’s exactly what the USPSTF Transparency and Accountability Act of 2015 (H.R. 1151/S. 1151) would do. The legislation calls for greater transparency and increased public input on the USPSTF’s decisions. It would require that the task force’s recommendation-development process be consistent with that of other federal agencies that create policy and regulations. The task force would also be required to include specialty providers, patients, and other stakeholders in order to broaden its expertise. The USPSTF would also need to submit its reports to an external panel for review. After this review, the public would have 60 days to submit comments. These new policies would bring the task force’s processes out from behind closed doors and support patients’ access to evidence-based care.

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