Washington Briefs:

Senate Finance Committee Curtails

Advanced Imaging Cuts Proposed by the House

Washington, DC [September 18, 2009] -- The Senate Finance Committee healthcare reform bill released earlier this week by Committee Chair, Max Baucus, spares imaging from the huge cuts proposed by three House Committees and the administration.

The Senate Finance Committee draft reduced cuts proposed in the House by 75%.

For the past four months, LCA has been part of a top level Washington based coalition to protect lung and all cancer patients from the impact of large Medicare cuts in imaging services under healthcare reform. Imaging has been singled out for over $40 billion in cuts to help reduce the cost of healthcare reform.

Both the House and the White House proposed changes in the Medicare reimbursement formula that would cut payments to non-hospital sites for CT, MRI, and PET scans and other advanced imaging procedures by over 20%.  This is in addition to the 19% cut in imaging payments that took effect two years ago in the deficit reduction legislation.

The "double whammy" would lead to the closure of many imaging sites, curtailment and delays in imaging tests, and would be a disincentive to bring new imaging technologies into the system.

Imaging has recently come under heavy attack.  Budget analysts say Medicare costs for imaging are rising too quickly and that many CT, MRI, PET and other advanced imaging procedures are being performed frivolously or as defensive medicine to protect against law suits.

Not so with cancer, said LCA, urging that at the very least more detailed studies must be done to determine where the imaging increases are occurring before imaging is cut across the board.

In a meeting earlier this month with the top health care policy staff at the Office of Management and Budget (OMB), LCA pointed out that all cancer patients require advanced imaging during the course of their disease and for follow-up.

LCA also noted that recent studies indicate that the overall number of people being diagnosed with cancer will grow by 45% over the next 20 years, with a 52% increase in lung cancer cases alone.

In his televised speech this month on healthcare reform the President

Stated, “[I]nsurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies -- because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse.  That makes sense, it saves money, and it saves lives.”

LCA told OMB officials it agreed wholeheartedly with the President that early detection saves lives and money.

But, LCA asked, how we give everyone colonoscopies and mammograms, how can we hope to bring image screening for lung and other cancers on board, and how do we handle a 50% increase in the cancer population if we are going to continue to cut advanced imaging?

While the cuts called for would apply to Medicare payments, private insurance companies usually follow suit. Thus all populations would feel the impact of these proposed cuts.

The action by the Senate Finance Committee is no guarantee that the reduced hit on imaging will make it through to the final package, which still must be cleared by Senate committees and both House of Congress, as well as the President.

LCA will continue to monitor and report on this legislation.  Stay tuned to www.lungcanceralliance.org for updates.