Medicare Compliance & Reimbursement

Some claim radiology will be lone beneficiary of plan.

The Medicare Payment Advisory Commission is asking Congress and the Department of Health and Human Services to break new ground when it comes to wringing value from the growing number of dollars spent on imaging services, said MedPAC Executive Director Mark Miller.

Under the recommendation, Congress would require HHS to set quality standards both for practitioners who interpret diagnostic imaging studies and for those who perform them.

New Guidelines Not Just For Radiology 

Many providers are complaining that new standards would lock up imaging services in one specialty: radiology. But that's not what commissioners intend, according to MedPAC Executive Director Mark Miller. The standards would simply require that anyone who performs imaging be sufficiently trained to narrow the widely varying error rates and to cut down on the high number of faulty procedures that must be redone, he said to health reporters at a March 1 briefing on the MedPAC's annual March recommendations to Congress.

The Commission does believe that imaging sucks in a large share of Medicare dollars without increasing quality of care, Miller indicated. Staff analysis has shown that, while more imaging is being done in doctors' offices, this isn't being offset by any drop in imaging in traditional facilities.

MedPAC analysts and Dartmouth Medical School researchers led by Jack Wennberg, MD, also have determined that a high volume of imaging services provided in a region does not correlate with better health outcomes, Miller said.