Is it possible that Washington, D.C. isn't as dysfunctional as it appears?
Facing likely helium shortages, the Senate last week passed an amended version of the Responsible Helium Administration and Stewardship Act (H.R. 527), which will enable the Federal Helium Reserve to continue production of the gas that is so critical in the use of MRIs.
Not only did the Senate pass the legislation, it did so by a 97-2 vote, indicating that when compelled to do so, our legislators can act rationally. That is further suggested by the fact that there also seems to be some movement in legislative efforts to repeal and replace the Sustainable Growth Rate.
The House Energy and Commerce Committee last month unanimously passed a bill called the Medicare Patient Access and Quality Improvement Act of 2013 (H.R. 2810), which not only would replace the despised SGR, but also of note to this audience contains some important imaging provisions. Language in the bill addresses the 25 percent professional component multiple procedure payment reduction (MPPR) by specifically requiring the Centers for Medicare & Medicaid Services to disclose the data that was used when the 25 percent cut was first proposed. Critics of the MPPR, such as the American College of Radiology (ACR), have long questioned the existence of the data.
In addition, the bill also contains provisions supporting the expansion of web-based clinical support tools, which makes sense if we're to move away from policies that cut utilization by drastically reducing reimbursement, and instead adopt strategies--like using clinical decision support--that emphasize imaging appropriateness.
What is particularly welcoming about these latest developments is that radiology and medical imaging no longer appear to be easy targets of federal policymakers looking for ways to cut costs. Over the last several years, whether through work done by advocacy groups like ACR, or research by professionals in the field, it's become increasingly clear that imaging no longer is a driving force behind escalating healthcare costs--a reality demonstrated by legislation like H.R. 2810.
Of course, there's still a ways to go before we see that bill passed. One hurdle is the Congressional Budget Office's estimate that passage of H.R. 2810 will cost $175 billion in spending by 2023. Coming up with ways to cover that increase certainly will complicate efforts to pass the bill.
But the House Ways and Means Committee and the Senate Finance Committee also are working on SGR-repeal legislation, so things at least are moving.