American College of Radiology members Cassandra Foens, M.D., medical director of radiation oncology at Covenant Cancer Treatment Center in Waterloo, Iowa, James P. Borgstede, M.D., vice chair of radiology at the University of Colorado, and Michael M. Graham, M.D., Ph.D., vice chair of radiology and director or nuclear medicine at the University of Iowa, lobbied members of the U.S. House of Representatives Rural Caucus on June 25 against using radiology benefits managers (RBMs) in the Medicare system.

The trio also urged against a proposed imaging equipment utilization rate change from 50 percent to 95 percent at the Capitol Hill briefing.

Selected by the ACR and the Access to Medicare Imaging Coalition, the three doctors linked up with representatives from the Lung Cancer Alliance and the Susan G. Komen Advocacy Alliance and highlighted the importance of medical imaging through earlier disease diagnosis, less invasive medical procedures, shorter hospital stays, and optimized patient treatment.

According to the ACR, “the doctors advised the members of Congress and congressional staff in attendance that RBMs take decisions out of the hands of physicians and patients, can cause delays in treatment, and form barriers to necessary imaging care for patients. The expert panel also educated attendees that further imaging cuts would have a devastating effect on the ability of physicians in rural areas to continue to provide much needed imaging care to patients.”

In reference to President Barack Obama’s proposal for an increase in the utilization rate, the doctors pointed to data recently collected by the Radiology Business Management Association showing that imaging centers in rural areas operate equipment approximately  48 percent of the time their offices are open. Non-rural centers operate equipment during approximately 56 percent of their office hours. The doctors said a 90-95 percent utilization rate for CT and MRI scans would result in an additional 30 percent or higer reimbursement cut for these modalities, in addition to an average 23-percent hit from imaging provisions in the Deficit Reduction Act of 2005 and reductions in the CMS’ proposed Physician Fee Schedule Rule.

In a statement, the ACR cautioned, “utilization assumption is the percentage of a facility’s operating time that the equipment is assumed to be in use and is a key component of the Medicare formula used to calculate reimbursement. If the assumption is dramatically higher than the actual time a facility’s machines are in use, the center will be significantly underpaid for their services.”