Regulatory and legislative actions taken this past week hold huge potential to improve both safety and integrity in radiology.
On Tuesday, the United States Preventive Services Task Force recommended that heavy smokers with a high risk of developing lung cancer be screened for cancer by undergoing annual low-dose CT scans.
This is a recommendation that has been eagerly awaited ever since results from the National Lung Screening Trial showed that low-dose CT screening could significantly reduce mortality rates for persons with a high risk of developing lung cancer. Since then, numerous medical organizations--ranging from the American College of Chest Physicians and the American Society of Clinical Oncology to the National Cancer Society--have endorsed low-dose CT lung cancer screening. Interested observers should read the draft recommendation statement and--if compelled to do so--submit a comment to the USPSTF by August 26.
The USPSTF should be commended for finally taking this step. When the draft recommendation is adopted, it will trigger Medicare and private insurance coverage of the scan, which will make the scans more affordable. That has the potential to lead to an increase in lung cancer survival rates.
Additionally this week, the "Promoting Integrity in Medicare Act of 2013" was introduced in the House by Reps. Jackie Speier (D-Calif.), and Jim McDermott (D-Wash.). The legislation would close the self-referral loophole for several services, including advanced imaging and radiation therapy.
The legislation was introduced the same day that the Government Accountability Office published its latest report on self-referral, this one on radiation therapy and prostate cancer. The GAO found that the incidence of intensity-modulated radiation therapy (IMRT) services increased significantly in self-referring groups between 2006 and 2010, while declining among non-self-referring groups.
The "higher use of IMRT by self-referring providers results in higher costs for Medicare and beneficiaries," the report stated. "To the extent that treatment decisions are driven by providers' financial interest and not by patient preference, these increased costs are difficult to justify."
This GAO report follows one published in 2012 on self-referral and advanced imaging services, in which it was determined that physician self-referrals were driving up utilization and costing Medicare over $100 million annually.
The idea of closing the self-referral loophole has never gone far in Congress. As an increasing number of organizations like the American Society for Radiation Oncology and the American College of Radiology exert pressure, perhaps will change. The Promoting Integrity in Medicare Act is as good a place as any to start. - Mike @FierceHealthIT