MedPAC Recommends New Imaging Payment System

The Medicare Payment Advisory Commission (MedPAC) considers several health care matters in its June 2011 Report to Congress. Creating controversy among the industry are the recommendations pertaining to ancillary services. A new payment system is in order, MedPAC says in the report; one that would reward physicians and hospitals for limiting the number of imaging services they provide. In its annual report to Congress, MedPAC makes these specific recommendations for improving payment accuracy and appropriate use of ancillary services: • Accelerate and expand efforts to package discrete services in the physician fee schedule into larger units for payment. • Apply a multiple procedure payment reduction to the professional component of diagnostic imaging services provided by the same practitioner in the same session. • Reduce the physician work component of imaging and other diagnostic tests that are ordered and performed by the same practitioner. • Establish a prior authorization program for practitioners who order substantially more advanced diagnostic imaging services than their peers.